急性脑梗死患者病情及预后与VASH-1、PN、NSE水平的关系研究OA

Objective To analyze the relationship between vasohibin-1(VASH-1),neuron-specific enolase(NSE),and periostin(PN)levels and the condition and prognosis of patients with acute cerebral infarction(ACI).Methods A total of 150 ACI patients admitted to the Department of Neurology,Beijing Rehabilitation Hospital Affiliated to Capital Medical University from May 2023 to April 2025 were selected as the study group.Patient condition was assessed using the National Institutes of Health Stroke Scale(NIHSS)and categorized as mild(NIHSS score ≤5),moderate(score range 6-15),or se-vere(score ≥ 16).Patients were followed up for 90 days,and short-term prognosis was evaluated using the modified Rankin Scale(mRS),dividing them into a poor prognosis subgroup and a good prognosis subgroup.Additionally,150 healthy individ-uals undergoing physical examinations during the same period were selected as the healthy control group.Serum levels of VASH-1,NSE,and PN were compared among patients with different conditions and prognoses.The relationships between these serum markers and the condition as well as short-term prognosis of ACI patients were analyzed,along with their value in assessing severe ACI and predicting short-term poor prognosis.Results Serum levels of VASH-1,PN,and NSE in the study group were significantly higher than those in the healthy control group(t=51.974,23.625,44.520,all P＜0.001).Among the 150 ACI patients,there were 51(34.00％),59(39.33％),and 40(26.67％)patients with mild,moderate,and severe conditions,respectively.Serum levels of VASH-1,PN,and NSE were significantly higher in severe patients than in moderate patients,and significantly higher in moderate patients than in mild patients(F=61.979,115.407,81.533,all P＜0.001).Serum levels of VASH-1,PN,and NSE in the poor prognosis subgroup were significantly higher than those in the good prognosis subgroup(t=11.019,11.353,13.811,all P＜0.001).Serum levels of VASH-1,PN,and NSE were positively correlated with the severity of ACI patients(r=0.338,0.409,0.397;P=0.015,0.009,0.011,respectively).The AUCs for serum VASH-1,PN,NSE,and their combination in assessing severe ACI patients were 0.854,0.870,0.859,and 0.881,respectively.The combined assessment was superior to each marker alone(differences were compared using DeLong's test)(Z=2.114,1.994,2.307;P=0.035,0.048,0.021,respectively).High expression levels of serum VASH-1,PN,and NSE were independent risk factors for poor prognosis in ACI patients[OR(95％CI)=1.018(1.008-1.029),1.427(1.187-1.715),1.343(1.178-1.530)].Conclusion Serum levels of VASH-1,NSE,and PN are associated with the condition and prognosis of ACI patients.Their individual and combined detection are valuable for assessing severe ACI and predicting poor prognosis.