血清FNDC5、ZEB1、THBS1水平与脑梗死患者病情程度的相关性及对神经功能康复预后预测价值OA

Objective:To explore the relationship between the levels of fibronectin type Ⅲ domain containing pro-tein 5(FNDC5),zinc finger E-box binding protein 1(ZEB1),and thrombospondin-1(THBS1)and the condition of patients with ischemic stroke(IS),as well as their predictive value for neurological function rehabilitation.Meth-ods:Prospectively,patients with IS who visited our hospital from September 2022 to September 2024 were selected as the IS group(n=147),and healthy individuals who underwent physical examinations during the same period(n=150)were selected as the control group.According to the national institute of health stroke scale(NIHSS)score,IS patients were assigned into the mild group(n=50),the moderate group(n=69),and the severe group(n=28).They were assigned into the good rehabilitation group(n=95)and the poor rehabilitation group(n=52)based on the modified rankin scale(mRS).The baseline data,clinical data,and levels of serum FNDC5,ZEB1,and THBS1 were compared between the groups.The influencing factors of neurological function rehabilitation were ana-lyzed.The receiver operating characteristic(ROC)curve was used to explore the predictive value of serum FNDC5,ZEB1,and THBS1 levels for neurological function rehabilitation.In addition,the relative risk of different levels for neurological function rehabilitation was analyzed based on the optimal cut-off value.Results:Compared with the control group,the serum FNDC5 level in the IS group was lower,while the serum ZEB1 and THBS1 levels were higher(P<0.05).With the progression of IS,the level of serum FNDC5 decreased successively(mild group>moderate group>severe group),and the lev-els of ZEB1 and THBS1 increased successively(mild group<moderate group<severe group)(P<0.05).Com-pared with the good rehabilitation group,the serum FNDC5 level in the poor rehabilitation group was lower,while the levels of ZEB1 and THBS1 were higher(P<0.05).The levels of FNDC5,ZEB1 and THBS1 were the influen-cing factors of neurological function rehabilitation(all P<0.05).The area under the curve(AUC)values of serum FNDC5,ZEB1 and THBS1 alone and in combination for predicting neurological function rehabilitation were 0.822(95%CI:0.755-0.899),0.763(95%CI:0.681-0.845),0.792(95%CI:0.716-0.868)and 0.936(95%CI:0.897-0.975),respectively.The predictive value of the combination of the three was relatively higher(Z combination-FNDC5=2.890,Z combination-ZEB1=3.719,Z combination-THBS1=3.285,all P<0.05).The risk of poor neurolog-ical function rehabilitation in patients with low-level FNDC5 and high-level ZEB1 and THBS1 was 3.991,3.474 and 3.546 times that of patients with high-level FNDC5 and low-level ZEB1 and THBS1(all P<0.05).Conclusion:The more severe the condition of IS patients is,the lower the serum FNDC5 will be,and the higher the levels of se-rum ZEB1 and THBS1 will be.The combination of the three has a high predictive value for the neurological function rehabilitation.