Objective To investigate the relationship between neutrophil apoptosis factors combined with thromboxane B2 and cerebral microcirculatory blood flow and limb function recovery in patients with acute ischemic stroke (AIS) after thrombolysis.

Methods A total of 84 AIS patients were analyzed retrospectively. They were divided into groups with low (52 cases) and high (32 cases) cerebral perfusion, based on post-thrombolytic CT imaging that assessed changes in cerebral blood flow (CBF) on the affected side. Additionally, following imaging assessments, patients were divided into a group with limb dysfunction (43 cases) and a group without impairment (41 cases). Data collection included patient perfusion metrics and standard clinical information, with a focus on comparing serum levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and plasma thromboxane B2 across the different groups. Pearson correlation analysis was conducted to examine the associations between relative CBF (rCBF), limb motor function as measured by the Fugl-Meyer assessment (FMA) scores, and the concentrations of IL-1β, TNF-α, and thromboxane B2 in AIS patients post-thrombolytic treatment. Furthermore, the predictive utility of IL-1β, TNF-α, and thromboxane B2 levels for identifying limb dysfunction in AIS patients was assessed using ROC curve analysis.

Results In the low perfusion group, AIS patients exhibited prolonged rMTT, rTmax, and rTTP compared to the high perfusion group, whereas rCBF and rCBV were reduced (P ＜ 0.05 to P ＜ 0.01). Serum concentrations of IL-1β, TNF-α, and plasma thromboxane B2 were lower in the low perfusion cohort versus the high perfusion one (P ＜ 0.05 to P ＜ 0.01). The non-limb dysfunction group demonstrated higher FMA and BBS scores compared to the limb dysfunction group (P ＜ 0.01 and P ＜ 0.05). The non-limb dysfunction group had decreased levels of serum TNF-α and plasma thromboxane B2 compared to the limb dysfunction group (P ＜ 0.01 and P ＜ 0.05), with a trend of lower serum IL-1β, though this did not reach statistical significance (P ＞ 0.05). Pearson correlation analysis indicated that serum IL-1β, TNF-α, and plasma thromboxane B2 levels were positively correlated with rCBF and negatively correlated with FMA scores in AIS patients (P ＜ 0.05). ROC curve analysis revealed AUCs for predicting limb dysfunction of 0.612 for IL-1β, 0.762 for TNF-α, 0.699 for thromboxane B2, and 0.784 for combined levels. The IL-1β level was not statistically significant (P ＞ 0.05), while the other markers were statistically significant (P ＜ 0.01).

Conclusions A strong association exists between serum neutrophil apoptosis factor, thromboxane B2 concentrations, and the status of cerebral microcirculation along with limb function recovery in AIS patients post-thrombolytic treatment. The combined measurement of IL-1β, TNF-α, and thromboxane B2 exhibits significant predictive power for the risk of limb dysfunction in AIS patients.