An investigation on dynamic changes and clinical significance of ADAMTS13 after intravenous thrombolysis in patients with acute cerebral infarction

JIANG Bing-jian; LU Huan-huan; HUANG Shu-xuan

doi:10.3969/j.issn.1674-3806.2023.12.05

Abstract：Objective To investigate the dynamic changes and clinical significance of a disintegrin and met-alloproteinase with a thrombospondin type 1 motif member 13(ADAMTS13)after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods The clinical data of eighty-three patients with mild and moderate ACI who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator(rt-PA)in the People's Hospital of Guangxi Zhuang Autonomous Region from January 2020 to December 2021 were collected.According to the National Institutes of Health Stroke Scale(NIHSS)scores of the patients at admission,they were divided into mild group(NIHSS scores≤5 points,44 cases)and moderate group(5 points＜NIHSS scores＜15 points,39 cases).The serum samples were collected before,24 hours and 72 hours after thrombolysis,and ADAMTS13 levels were detected using Luminex technology.The correlation of ADAMTS13 level with the severity and prognosis of ACI was analyzed.Results Compared with those in the mild group and the moderate group before thrombolysis,the ADAMTS13 levels in the mild group and the moderate group showed a downward trend after thrombolysis,and there was no significant differ-ence in ADAMTS13 level between the two groups at each time point(P＞0.05).The results of multivariate logistic regression analysis showed that the ADAMTS13 level before thrombolysis was not significantly correlated with the severity of the patients'condition at admission[OR(95%CI)=0.280(0.036-2.196),P =0.226],and a higher ADAMTS13 level 72 hours after thrombolysis was a protective factor against adverse outcomes in the ACI patients 90 days after treatment[OR(95%CI)=0.556(0.005-0.991),P =0.049].The results of receiver operating characteristic(ROC)curve analysis indicated that the ADAMTS13 level 72 hours after thrombolytic therapy had the application value of pre-dicting 90-day prognosis of the ACI patients after treatment[area under the curve(AUC)(95%CI)=0.693(0.547-0.839),P =0.021],with an optimal cut-off value of 5.860,and the corresponding sensitivity and specificity were 76.90%and 56.50%,respectively.Conclusion Serum ADAMTS13 levels in ACI patients show a downward trend in the early stage after intravenous thrombolysis,and a higher ADAMTS13 level 72 hours after thrombolysis is a pro-tective factor that inhibits the adverse prognosis of the ACI patients 90 days after treatment.