急性缺血性脑卒中伴脑微出血患者血清NOX4、FNDC5、CCL23水平变化及其与预后的关系OA

Objective To investigate the changes in the serum levels of nicotinamide adenine dinucleotide phos-phate oxidase 4(NOX4),fibronectin type Ⅲ domain-containing protein 5(FNDC5),and chemokine(C-C motif)ligand 23(CCL23)in patients with acute ischemic stroke(AIS)complicated by cerebral microbleed(CMB),as well as their as-sociation with prognosis.Methods A total of 305 AIS patients who were admitted to Zhangjiakou First Hospital from Au-gust 2021 to August 2024 were enrolled,and according to the presence or absence of CMB,they were divided into non-CMB group with 195 patients and CMB group with 110 patients.According to the prognosis,the AIS patients with CMB were divided into good prognosis group with 68 patients and poor prognosis group with 42 patients.The Spearman's corre-lation coefficient was used to assess the correlation of the serum levels of NOX4,FNDC5,and CCL23 with National Insti-tutes of Health Stroke Scale(NIHSS)score;a multivariate logistic regression model analysis was used to investigate the in-fluencing factors for the prognosis of AIS patients with CMB;the receiver operating characteristic(ROC)curve was used to assess the performance of the serum levels of NOX4,FNDC5,and CCL23 in predicting the prognosis of AIS patients with CMB.Results Compared with the non-CMB group,the CMB group had significant increases in the serum levels of NOX4 and CCL23(P<0.05)and a significant reduction in the serum level of FNDC5(P<0.05),and compared with the good prognosis group,the poor prognosis group had significant increases in the serum levels of NOX4 and CCL23(P<0.05)and a significant reduction in the serum level of FNDC5(P<0.05).In the AIS patients with CMB,the serum levels of NOX4 and CCL23 were positively correlated with NIHSS score(rs=0.587 and 0.605,both P<0.05),while the serum level of FNDC5 was negatively correlated with NIHSS score(rs=-0.584,P<0.05).The serum levels of NOX4,FNDC5,and CCL23 were influencing factors for the prognosis of AIS patients with CMB(OR=3.114,0.559,and 3.465,all P<0.05).The combination of serum NOX4,FNDC5,and CCL23 had a larger area under the ROC curve than each indicator used alone in predicting the prognosis of patients(Z=3.043,2.662,and 2.536,all P<0.05).Conclusion There are increases in the serum levels of NOX4 and CCL23 and a reduction in the serum level of FNDC5 in AIS patients with CMB.NOX4,CCL23,and FNDC5 have a certain value in predicting the prognosis of patients,and the combination of these three indica-tors has a better predictive performance.