脑梗死急性期患者血清CXCR4水平与颈动脉斑块易损性及复发风险的相关性研究OA

Objective To investigate the association of the serum level of CXC chemokine receptor 4(CXCR4)with the vulnerability and recurrence risk of carotid plaques in patients in the acute stage of cerebral infarction.Methods A total of 150 patients in the acute stage of cerebral infarction who were admitted to our hospital from March 2019 to March 2025 were enrolled as subjects,and according to the nature of plaques,they were divided into vulnerable plaque group with 86 patients and stable plaque group with 64 patients.A hierarchical regression analysis was used to in-vestigate the influence of carotid plaque vulnerability on the serum level of CXCR4,a Logistic regression analysis was used to analyze the association between CXCR4 level and plaque vulnerability,and a log-binomial regression analysis was used to explore the association between CXCR4 level and vulnerable plaque subtypes.The patients were divided into recurrence group with 48 patients and non-recurrence group with 102 patients according to the presence or absence of recurrence,and a Logistic regression analysis was used to investigate the independent association between serum CXCR4 level and recur-rence risk and the correlation between them in different subgroups.A restricted cubic spline model was used to investigate the dose-response relationship between serum CXCR4 level and recurrence risk.Results The hierarchical regression analysis showed that intraplaque hemorrhage(IPH),lipid-rich necrotic core(LRNC),fibrous cap rupture(FCR),calci-fication volume,LRNC volume,IPH volume,and plaque load(PL)were positively correlated with the serum level of CXCR4(P<0.05).The Logistic regression analysis showed that after exclusion of confounding factors,CXCR4 level was still independently associated with carotid plaque vulnerability(P<0.05),with the highest association with ruptured plaques and the lowest association with concentric plaques.The Logistic regression analysis also showed that serum CXCR4 level was independently correlated with recur-rence risk in patients.The subgroup analysis showed that in different subgroups based on LRNC,FCR,and calcification volume,there was a stable correlation be-tween CXCR4 level and recurrence risk(P<0.05).The restricted cubic spline analysis showed that the there was a non-linear positive correlation between CXCR4 level and recurrence risk(P<0.05),espe-cially when the level of CXCR4 exceeded 7.55 µg/L,and recurrence risk significantly increased with the increase in CXCR4 level.Conclusion The serum level of CXCR4 is positively correlated with the characteristics of carotid plaque vulnerability such as IPH,LRNC,FCR,calcification vol-ume,LRNC volume,IPH volume,and PL,and therefore,it can be used as a potential predictive factor for recurrence risk.