血清miR-24-3p、sTim-3对急性缺血性脑卒中患者预后不良的预测价值OA

Objective To investigate the predictive value of serum microRNA-24-3p(miR-24-3p)and solu-ble T-cell immunoglobulin and mucin domain-containing molecule 3(sTim-3)for poor prognosis in patients with acute ischemic stroke(AIS).Methods A total of 150 patients with AIS admitted to the hospital from January 2022 to December 2024 were selected as the AIS group,and 150 healthy community volunteers with-out a history of stroke who underwent physical examination at the hospital during the same period were se-lected as the control group.According to the modified Rankin Scale score at three months after discharge,the AIS patients were divided into a good prognosis group and a poor prognosis group.Serum levels of miR-24-3p and sTim-3 were measured in all study subjects.Pearson correlation analysis was performed to evaluate the correlation of serum miR-24-3p and sTim-3 levels with the National Institutes of Health Stroke Scale(NIH-SS)score in AIS patients.Multivariate Logistic regression analysis was performed to identify the influencing factors for poor prognosis in AIS patients,and a nomogram prediction model was constructed based on the i-dentified factors.Results The serum level of miR-24-3p in the AIS group was significantly lower than that in the control group(P<0.05),whereas the serum level of sTim-3 in the AIS group was significantly higher than that in the control group(P<0.05).At admission,the serum level of miR-24-3p in AIS patients was negatively correlated with the NIHSS score(P<0.05),while the serum level of sTim-3 was positively corre-lated with the NIHSS score(P<0.05).Among the 142 AIS patients,46 had poor prognosis.The serum level of miR-24-3p in the poor prognosis group was significantly lower than that in the good prognosis group(P<0.05),and the serum level of sTim-3 in the poor prognosis group was significantly higher than that in the good prognosis group(P<0.05).Increased age,comorbid hypertension,elevated NIHSS score at admission,and elevated serum sTim-3 level were identified as independent risk factors for poor prognosis in AIS patients(P<0.05),whereas an elevated serum miR-24-3p level was identified as an independent protective factor(P<0.05).For the nomogram prediction model constructed based on multivariate Logistic regression,the ar-ea under the curve(AUC)for predicting poor prognosis in AIS patients was 0.931,with an optimal cut-off value of 0.583,a sensitivity of 93.48%,and a specificity of 85.42%.The Hosmer-Lemeshow goodness-of-fit test,calibration curve,and decision curve analysis confirmed that the model exhibited good calibration and clinical utility.Conclusion Decreased serum miR-24-3p level and increased serum sTim-3 level are closely as-sociated with poor prognosis in AIS patients.The combination of these two indicators with clinical characteris-tics demonstrates high predictive value for poor prognosis in AIS patients,providing a reference basis for clini-cal assessment of disease status and the formulation of intervention strategies.