Correlation between FGF23,ANGPTL4,apelin-13 and disease condition and short-term prognosis of thrombolytic therapy in patients with acute ischemic stroke
Objective To explore the relationship of fibroblast growth factor 23(FGF23),angiopoietin like protein 4(ANGPTL4)and apelin-13 with disease condition and short-term prognosis of thrombolytic therapy in patients with acute ischemic stroke(AIS). Methods A total of 120 patients with AIS were selected from Beijing Rehabilitation Hospital Affiliated to Capital Medical University from July 2020 to July 2023. The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the degree of neurological impairment upon admission. The patients were then divided into three groups:mild(35 cases),moderate(54 cases)and severe(31 cases). The size of the infarct lesion in the patients was evaluated using cranial MRI and they were classified into three groups:lacunar cerebral infarction group(31 cases),medium-area infarction group(52 cases)and large-area cerebral infarction group(37 cases). The modified Rankin scale was used to assess the prognosis of the patients 90 days after thrombolytic therapy. They were categorized into two groups:good prognosis group(82 cases)and poor prognosis group(38 cases). The levels of serum FGF23,ANG-PTL4 and apelin-13 were compared among each group. Multivariate logistic regression was then applied to ana-lyze the factors that influence the short-term prognosis in AIS patients. Results The serum FGF23 levels in AIS patients with different degrees of neurological injury were found to be mild group <moderate group <severe group. Conversely,the levels of serum ANGPTL4 and apelin-13 were mild group>moderate group>severe group. These differences were all statistically significant(F=9.685,8.418,13.695,P<0.05). In AIS patients with different infarct sizes,the serum FGF23 levels were observed to be lacunar cerebral infarction group <medium-area infarction group <large-area infarction group. On the other hand ,the levels of serum ANGPTL4 and apelin-13 were lacunar cerebral infarction group>medium-area infarction group>large-area infarction group. These differences were all statistically significant(F=8.652,7.579,18.659,P<0.05). Furthermore,the age,maximum lesion diameter,NIHSS score at admission and serum FGF23 levels in the poor prognosis group were higher than those in the good prognosis group. Conversely,the levels of serum ANGPTL4 and apelin-13 were lower in the poor prognosis group compared to the good prognosis group(t=3.147, 4.725,7.309,3.364,4.869,5.766,P<0.05). The maximum diameter of the lesion≥ 5 cm,NIHSS score≥20 points at admission and high levels of FGF23 were identified as independent risk factors for poor short-term prognosis of AIS patients treated with intravenous thrombolysis. Conversely,high levels of ANGPTL4 and apelin-13 were found to be protective factors(P<0.05). Conclusion FGF23,ANGPTL4 and apelin-13 are closely related to the severity and short-term prognosis of AIS patients. Detecting the level of these three indicators is helpful in evaluating the disease condition and prognosis of AIS.
万方数据
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