Predictive Effect of Dynamic Trajectory of Serum DPP3 on Functional Outcome in Patients with Acute Anterior Circulation Cerebral Infarction
YUAN Xiaona
GONG Xiyun
YANG Yuxia
PENG Nana
Abstract：Objective To investigate the predictive effect of dynamic trajectory of serum dipeptidyl peptidase 3(DPP3)on functional outcome in patients with acute anterior circulation cerebral infarction.Methods A total of 291 acute anterior circulation cerebral infarction patients in the First Affiliated Hospital of Zhengzhou University from May 2023 to January 2025 were selected as the research objects for a prospective study.All patients were treated with thrombolytic therapy.The serum DPP3 level was detected before treatment,1 h,24 h and 7 d after treatment.The latent class trajectory model(LCTM)was used to analyze the dynamic trajectory of serum DPP3 and establish the trajectory model.The KM curve was used to analyze the 90-day functional outcome after thrombolysis in different trajectory groups,and the clinical data of different trajectory groups were compared.Logistic regression analysis was employed to investigate the relationship between the dynamic trajectory of serum DPP3 and functional outcomes.The receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the predictive value of the dynamic trajectory of serum DPP3 for functional outcomes.Results The serum DPP3 levels of 291 acute anterior circulation cerebral infarction patients before treatment,1 hour after treatment,24 hours after treatment,and 7 days after treatment were(6.33±2.03)mg·L-1,(4.42±1.30)mg·L-1,(3.05±0.92)mg·L-1,and(2.32±0.57)mg·L-1,respectively,showing a continuous decreasing trend,and the difference was statistically significant(P＜0.05).The LCTM model ultimately identified three dynamic trajectory groups of serum DPP3:group T1(low-lower trajectory),group T2(medium-high-low trajectory),and group T3(higher-high trajectory).The results of repeated measurement analysis of variance showed that the serum DPP3 levels of the three groups at different time points were gradually decreased,and the serum DPP3 levels of group Tl were lower than group T2 and group T3 before treatment,1 h,24 h and 7 d after treatment,group T2 was lower than group T3,with statistically significant differences(P＜0.05).There were significant differences in infarct volume,National Institutes of Health stroke scale(NIHSS)score at admission,and time from onset to admission among the three groups(P＜0.05).After a 90-day follow-up,234 patients(80.41％)had a good outcome,while 57 patients(19.59％)had a poor outcome.According to the KM curve analysis,the cumulative poor functional outcome rate in group T3 was 47.37％,which was significantly higher than that in group T1(6.52％)and group T2(10.65％),with a statistically significant difference(x2=50.794,P＜0.05).Logistic regression analysis showed that after adjusting for other factors,the association strength between group T3 and the risk of poor functional outcome was OR=2.707 and 2.151(P＜0.05)when referring to group T1 and group T2,respectively.ROC curve indicated that the AUC of serum DPP3 dynamic trajectory for predicting poor functional outcome in acute anterior circulation cerebral infarction patients at T3 was 0.730(0.675-0.780),with a sensitivity of 63.16％and a specificity of 82.91％.Conclusion There are three kinds of change tracks of serum DPP3 level in acute anterior circulation cerebral infarction patients before and after treatment.The high-high track has a certain predictive value for the functional outcome after 90 days of treatment,which can provide a risk stratification tool for clinical accurate prediction and guide the follow-up individualized intervention.
Keywords：acute anterior circulation cerebral infarctiondipeptidyl peptidase 3trajectory modelfunctional outcomeprediction
Publication Date：2026-06-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：7( 1970-1976 )