Predictive value of serum CCL5 and P2X7R levels in acute ischemic stroke with large vessel occlusion complicated with malignant brain edema
Objective To investigate the predictive value of serum levels of C-C motif chemokine ligand 5(CCL5)and purinergic 2X7 receptor(P2X7R)in acute ischemic stroke with large vessel occlusion(AIS LVO)complicated with malignant cerebral edema(MBE).Methods Totally 162 patients with AIS-LVO(observation group)were selected.After receiving intravenous thrombolysis combined with mechanical thrombectomy,43 cases with MBE and 119 cases without MBE were diagnosed 72 h later,and 60 healthy volunteers were selected as the control group during the same period.Periph-eral venous blood of all subjects was collected,serum was collected by centrifugation,and serum CCL5 and P2X7R were de-tected by ELISA.Multivariate Logistic regression model was used to analyze the risk factors of AIS-LVO complicated with MBE,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum CCL5 and P2X7R levels in AIS-LVO complicated with MBE.Results The serum levels of CCL5 and P2X7R in the observation group were higher than those in the control group(both P<0.05).Univariate analysis showed that NIHSS score,ASPECTS score and serum CCL5 and P2X7R levels of AIS-LVO patients with MBE were higher than those of AIS-LVO patients without MBE(all P<0.05).Multivariate Logistic regression analysis showed that the increase of NIHSS score and serum CCL5 and P2X7R levels were independent risk factors for AIS-LVO complicated with MBE(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum CCL5 and P2X7R levels independently and jointly in predicting AIS-LVO complicated with MBE were 0.780,0.790 and 0.880,respectively.The AUC of serum CCL5 and P2X7R combined in predicting AIS-LVO complicated with MBE was greater than that of either alone(both P<0.05).Conclusions Increased levels of serum CCL5 and P2X7R are independent risk factors for AIS-LVO complicated with MBE.Serum CCL5 and P2X7R levels have certain predictive value for AIS-LVO complicated MBE,and the combined detection of the two has a higher predictive value.
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