血清LRRK2、SMAD3、PGE2水平变化与急性脑出血患者神经功能缺损程度的关系及对预后的影响OA

Objective To explore the correlations between serum levels of leucine-rich repeat kinase 2(LRRK2),Smad homolog 3(SMAD3),and prostaglandin E2(PGE2)and the severity of neurological deficits in patients with acute cere-bral hemorrhage,and to evaluate the predictive value of these three biomarkers for short-term prognosis.Methods A total of 124 patients with acute cerebral hemorrhage admitted to the Department of Neurosurgery of Ningde Hospital(Ningde Hospital of Shanghai First People's Hospital)from October 2022 to October 2025 were selected as the study group,and 50 healthy in-dividuals undergoing physical examination were selected as the healthy control group.Patients were classified into mild,mod-erate,and severe neurological deficit subgroups based on the National Institutes of Health Stroke Scale(NIHSS)score at ad-mission,and into good and poor prognosis subgroups according to the modified Rankin Scale(mRS)score at 90 days after on-set.Serum levels of LRRK2,SMAD3,and PGE2 were measured by enzyme-linked immunosorbent assay.Correlations be-tween each biomarker and NIHSS score were analyzed.Logistic regression was used to identify risk factors for poor progno-sis.Receiver operating characteristic(ROC)curves were constructed to evaluate the predictive value of serum LRRK2,SMAD3,and PGE2 for poor prognosis.Patients were divided into high-and low-level groups based on the optimal cut-off values derived from ROC curves,and relative risk(RR)was calculated to assess the impact of different indicator levels on prognosis.Results Serum levels of LRRK2,SMAD3,and PGE2 in the study group were significantly higher than those in the healthy control group(t=12.741,7.443,18.966,all P<0.001).Serum LRRK2,SMAD3,and PGE2 levels increased pro-gressively across the mild,moderate,and severe subgroups(F=26.936,32.720,91.531,all P<0.001),and all three were signif-icantly positively correlated with NIHSS score(r=0.612,0.573,0.648,all P<0.001).Admission NIHSS score and serum levels of LRRK2,SMAD3,and PGE2 were significantly higher in the poor prognosis subgroup than in the good prognosis subgroup(t=9.043,6.812,8.040,7.141,all P<0.001).Elevated admission NIHSS score(OR=3.028,95%CI:1.669-5.494),LRRK2(OR=2.292,95%CI:1.348-3.898),SMAD3(OR=2.196,95%CI:1.327-3.634),and PGE2(OR=2.414,95%CI:1.257-4.637)were independent risk factors for poor prognosis.The AUCs of serum LRRK2,SMAD3,PGE2,and their combination for predicting poor prognosis were 0.828,0.829,0.821,and 0.930,respectively,with the combined model demonstrating superior predictive performance(Z=2.479,2.929,2.757,all P<0.001).Based on the optimal cut-off values(LRRK2≥84.35 pg/mL,SMAD3≥407.86 pg/mL,PGE2≥175.73 pg/mL),the risks of poor prognosis for patients with high levels of LRRK2,SMAD3,and PGE2 were 4.667-fold(95%CI:2.551-8.837),4.035-fold(95%CI:2.468-6.597),and 5.583-fold(95%CI:2.841-10.973)higher,respectively,compared with those with low levels.Conclusion Serum LRRK2,SMAD3,and PGE2 levels are significantly elevated in patients with acute cerebral hemorrhage and are closely associated with the severity of neurological deficits.All three are independent risk factors for poor short-term prognosis.Combined detection of these biomarkers may more effectively assess disease severity and predict adverse outcomes,potentially serving as novel auxiliary biomarkers for clinical diagnosis and treatment of acute cerebral hemorrhage.