Serum CCL21 and CXCR3 predict stroke-associated pneumonia in patients with acute ischemic stroke
Objective To investigate the predictive value of serum levels of C-C motif chemokine ligand 21(CCL21)and C-X-C motif chemokine receptor 3(CXCR3)for stroke-associated pneumonia(SAP)in patients with acute ischemic stroke(AIS).Methods Patients with AIS admitted to No.215 Hospital of Shaanxi Nuclear Industry from July 2020 to December 2023 were prospectively included.Serum CCL21 and CXCR3 test results and general clinical data at admission were collected using the hospital electronic medical record system.The independent influencing factors of SAP were identified through multivariate logistic regression analysis,and the predictive value of serum CCL21 and CXCR3 levels for SAP were analyzed by receiver operating characteristic(ROC)curves.Results A total of 150 patients with AIS were enrolled,including 91 males(60.67％),aged 61.48±7.92 years.Among them,41 patients(27.33％)developed SAP during hospitalization.There were significant differences in serum CCL21 and CXCR3 levels,National Institutes of Health Stroke Scale score,Glasgow Coma Scale score,invasive mechanical ventilation,length of hospital stay,and the proportion of patients with hypertension and diabetes between the SAP group and the non-SAP group(all P＜0.05).Multivariate logistic regression analysis showed that serum CCL21(odds ratio[OR]1.022,95％confidence interval[CI]1.006-1.039;P=0.006)and CXCR3(OR 1.036,95％CI 1.018-1.054;P＜0.001)levels were the independent risk factors for SAP.ROC curve analysis showed that serum CCL21 and CXCR3 levels had good predictive power separately for SAP.The areas under the curve was 0.730(95％CI 0.634-0.825)and 0.807(95％CI 0.721-0.892),respectively.The combined prediction of the two showed an area under the curve of 0.881(95％CI 0.819-0.943).Conclusion The patients with AIS generally have higher levels of serum CCL21 and CXCR3.The levels of serum CCL21 and CXCR3 are closely associated with SAP,and both of them have a good predictive effect on SAP alone or in combination.
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