Abstract: Objective  To explore the value of serum 3-nitrotyrosine (3-NT) and serpin protease inhibitors B1 (SerpinB1) levels in predicting prognosis of elderly patients with acute ischemic stroke after intravenous thrombolysis.
Methods  Elderly (≥65 years old) patients with acute ischemic stroke treated in the Department of Neurology, Yan'an University Affiliated Hospital from January 2019 to January 2021 were prospectively and continuously included. According to 90-day mRS score, patients were divided into good prognosis group (0-2 points) and poor prognosis group (>2 points). Serum 3-NT and SerpinB1 levels were collected at baseline and before thrombolysis. Multivariate logistic regression was used to analyze the risk factors of poor prognosis.
Results   A total of 80 elderly patients with acute ischemic stroke who received intravenous thrombolytic therapy were included, including 45 patients in the good prognosis group and 35 patients in the poor prognosis group. The SerpinB1 level in the poor prognosis group was higher than that in the good prognosis group [(75.24±8.54) ng/mL vs. (57.32±5.68) ng/mL, P<0.001], and the 3-NT expression the in poor prognosis group was also higher than good prognosis group [(75.67±11.22) ng/mL vs. (61.68±11.54) ng/mL, P<0.001]. ROC curve showed that when the 3-NT cutoff value at 70.23 ng/mL, the sensitivity and specificity of predict value of prognosis for acute ischemic stroke in the elderly were 72.54% and 73.28%. When the cut-off value of SerpinB1 was 68.17 ng/mL, the sensitivity of predict value of prognosis for acute ischemic stroke in the elderly was 66.55% and the specificity was 78.64%. Multivariate regression analysis showed that the high NIHSS score (OR 6.404, 95%CI 3.993-10.271, P<0.001), high SerpinB1 expression (OR 26.154, 95%CI 11.460-59.690, P<0.001) and high 3-NT expression (OR 12.769, 95%CI 4.635-35.174, P<0.001) were the risk factors for poor prognosis of intravenous thrombolysis in elderly patients with acute ischemic stroke. 
Conclusions  Baseline serum 3-NT and SerpinB1 have certain value in the prognosis assessment of elderly patients with acute ischemic stroke after intravenous thrombolysis.

Key words: 3-nitrotyrosine; Serine protease inhibitors B1; Acute ischemic stroke; Prognosis

摘要： 目的 探讨及研究血清3-硝基酪氨酸（3-nitrotyrosine，3-NT）、丝氨酸蛋白酶抑制剂B1（serine protease inhibitors B1，SerpinB1）水平对老年急性缺血性卒中患者静脉溶栓预后的预测价值。
方法 前瞻性连续纳入2019年1月—2021年1月延安大学附属医院神经内科收治的老年（≥65岁）急性缺血性卒中静脉溶栓患者，根据患者90 d mRS评分分为预后良好组（0～2分）和预后不良组（＞2分）。收集患者基线临床资料、溶栓前血清3-NT和SerpinB1水平，采用多因素logistic回归分析不良预后的危险因素。
结果 共纳入80例接受静脉溶栓治疗的老年急性缺血性卒中患者，其中预后良好组45例，预后不良组35例。预后不良组SerpinB1水平高于预后良好组[（75.24±8.54）ng/mL vs.（57.32±5.68）ng/mL，P<0.001]；预后不良组3-NT水平高于预后良好组[（75.67±11.22）ng/mL vs.（61.68±11.54）ng/mL，P<0.001]。ROC分析显示，当3-NT截断值为70.23 ng/mL时，评估老年急性缺血性卒中患者静脉溶栓预后不良的敏感度为72.54%，特异度为73.28%；SerpinB1截断值为68.17 ng/mL时，评估老年急性缺血性卒中患者静脉溶栓不良预后的敏感度为66.55%，特异度为78.64%。多因素回归分析显示，高NIHSS评分（OR=6.404，95%CI 3.993～10.271，P<0.001）、SerpinB1高水平（OR=26.154，95%CI 11.460～59.690，P<0.001）、3-NT高水平（OR=12.769，95%CI 4.635～35.174，P<0.001）是老年急性缺血性卒中患者静脉溶栓预后不良的危险因素。
结论 基线血清3-NT、SerpinB1水平在老年急性缺血性卒中患者静脉溶栓的预后评估中具有一定价值。

关键词: 3-硝基酪氨酸; 丝氨酸蛋白酶抑制剂B1; 急性缺血性卒中; 预后