Prognostic value of serum sOX40L and ADAMTS-4 combined detection in elderly patients with acute cerebral infarction
Objective To analyze the prognostic value of the combination of serum soluble OX40 ligand(sOX40L)and A disintegrin and metalloproteinase with thrombospondin motifs-4(ADAMTS-4)in elderly patients with acute cerebral infarction.Methods Elderly patients with acute cerebral infarction who visited in the Baoding First Central Hospital from July 2019 to August 2023 were selected as the cerebral infarction group(n=121),and were separated into a good prognosis group(n=78)and a poor prognosis group(n=43)based on the prognosis mRS score.According to the degree of brain injury,it was divided into mild(n=31),moderate(n=57)and severe injury groups(n=33).Additionally,healthy individuals who underwent physical examination were regarded as the healthy group(n=68).Enzyme linked immunosorbent assay(ELISA)was applied to detect and compare serum levels of sOX40L and ADAMTS-4.Clinical data of patients were collected and analyzed.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum sOX40L and ADAMTS-4 levels for the prognosis of elderly patients with acute cerebral infarction.Logistic regression was applied to analyze the factors affecting the prognosis of elderly patients with acute cerebral infarction.Results The serum levels of sOX40L and ADAMTS-4 in the cerebral infarction group were greatly higher than those in the healthy group,all the differences were statistically significant(t=13.946,14.297;all P<0.05),and the serum levels of sOX40L and ADAMTS-4 increased with the severity of brain injury;all the differences were statistically significant(F=31.900,22.080;all P<0.05).The serum levels of sOX40L and ADAMTS-4 in the poor prognosis group were greatly higher than those in the good prognosis group;all the differences were statistically significant(t=10.240,9.433;all P<0.05).The location of cerebral infarction,NIHSS score at admission,and Hcy level were greatly different between the two groups;all the differences were statistically significant(t=5.178,8.818,6.121;all P<0.05).Moreover,posterior circulation cerebral infarction,high NIHSS score,elevated Hcy,sOX40L,and ADAMTS-4 levels were all risk factors for poor prognosis in elderly patients with acute cerebral infarction(all P<0.05).The AUCs of sOX40L,ADAMTS-4,and their combination in predicting the prognosis of elderly patients with acute cerebral infarction were 0.872,0.879 and 0.952,respectively,with higher combined predictive value(Zcombination vs.sOX40L=2.794,P=0.005;Zcombination vs.ADAMTS-4=2.340,P=0.019).Conclusions The serum levels of sOX40L and ADAMTS-4 in elderly patients with acute cerebral infarction were greatly increased.The changes in these two levels might become indicators for predicting the prognosis of acute cerebral infarction,and the combined predictive value of the two were higher.
Soluble OX40 ligandA disintegrin and metalloproteinase with thrombospondin motifs-4Acute cerebral infarction
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