The Usefulness of Factor XIII Concentration Assessment in Patients in the Acute Phase of Ischaemic Stroke Treated with Thrombolysis

IF 3.2 Q2 CLINICAL NEUROLOGY

Neurology International Pub Date : 2024-05-10 DOI:10.3390/neurolint16030041

Małgorzata Wiszniewska, Urszula Włodarczyk, Magdalena Sury, Artur Słomka, Natalia Piekuś-Słomka, Anna Żdanowicz, Ewa Żekanowska

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引用次数: 0

Abstract

Background and Aims: In recent years, there has been a growing interest in factor XIII in ischaemic stroke. The study’s main aim was to assess the usefulness of factor XIII concentration determination in patients with acute ischaemic stroke (AIS) treated with thrombolysis with recombinant tissue plasminogen activator (t-PA). Methods: The study was conducted in two groups of 84 patients with AIS: group I—with thrombolytic therapy and group II—without thrombolysis. A physical examination, neurological status (using the National Institutes of Health Stroke Scale, NIHSS), daily patients’ activities measured with the Barthel Index and Modified Rankin Scale (mRS), and blood parameters were conducted on day 1 and day 7. The following parameters were assessed: highly sensitive C-reaction protein (CRP), fibrinogen, D-dimers (DD), neutrophil–lymphocyte ratio (NLR index), and the concentration of factor XIII-A. Results: In group I, the concentration of XIII-A decreased significantly between day 1 and 7 (p < 0.001). In group I, the concentration of XIII-A on day 7 in Total Anterior Circulation Infarct (TACI) was significantly lower than in non-TACI stroke. XIII-A concentration in group I was significantly lower in patients < 31 points with Acute Stroke Registry and Analysis of Lausanne (ASTRAL). A greater decrease in XIII-A between the first sampling on day 1 and the second sampling on day 7 was associated with a worse patient neurological state in group I. Conclusions: In patients with AIS treated with t-PA, factor XIII concentrations decrease in the acute phase of stroke, and the largest decrease occurs in the TACI stroke. Determination of factor XIII concentration in patients with AIS can be used in clinical practice as an additional parameter supporting the assessment of stroke severity and may play a role in the prognosis; lower factor XIII-A activity may be a predictor of a worse prognosis.

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对接受溶栓治疗的缺血性脑卒中急性期患者进行因子 XIII 浓度评估的作用

背景和目的：近年来，人们对缺血性中风患者体内 XIII 因子的兴趣与日俱增。本研究的主要目的是评估急性缺血性脑卒中（AIS）患者接受重组组织浆细胞酶原激活剂（t-PA）溶栓治疗后，测定 XIII 因子浓度的作用。研究方法研究在两组 84 名急性缺血性中风（AIS）患者中进行：第一组（接受溶栓治疗）和第二组（未接受溶栓治疗）。在第 1 天和第 7 天分别对患者进行体格检查、神经系统状况（使用美国国立卫生研究院卒中量表 NIHSS）、使用 Barthel 指数和改良 Rankin 量表（mRS）测量的患者日常活动情况以及血液参数。对以下参数进行了评估：高敏性 C 反应蛋白（CRP）、纤维蛋白原、D-二聚体（DD）、中性粒细胞-淋巴细胞比率（NLR 指数）和 XIII-A 因子浓度。结果显示在 I 组中，XIII-A 的浓度在第 1 天和第 7 天之间明显下降（P < 0.001）。在第一组中，全前循环梗死（TACI）患者第 7 天的 XIII-A 浓度明显低于非 TACI 中风患者。在洛桑急性卒中登记和分析（ASTRAL）中，Ⅰ组小于 31 分的患者 XIII-A 浓度明显较低。在第1天第一次取样和第7天第二次取样之间，XIII-A的降幅越大，I组患者的神经状态越差：在接受 t-PA 治疗的 AIS 患者中，XIII 因子浓度在中风急性期会下降，TACI 中风患者的下降幅度最大。在临床实践中，测定 AIS 患者的 XIII 因子浓度可作为评估中风严重程度的附加参数，并可能在预后中发挥作用；较低的 XIII-A 因子活性可能预示着较差的预后。

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来源期刊

Neurology International CLINICAL NEUROLOGY-

CiteScore

3.70

自引率

3.30%

发文量

审稿时长

11 weeks