Predictive efficacy of serum FSTL1 and USF2 levels before intravenous thrombolysis on hemorrhagic transformation after thrombolysis in patients with acute ischemic stroke
DAI Fang
LI Yinghong
GUO Shuli
YAO Qingping
Abstract：Objective To observe the changes of serum follistatin-like protein 1(FSTL1)and upstream stimulating factor-2(USF2)levels before intravenous thrombolysis in acute ischemic stroke(AIS)patients with hemorrhagic transfor-mation(HT)after intravenous thrombolysis,and to analyze their predictive efficacy for HT after intravenous thrombolysis in AIS patients.Methods A total of 429 patients with AIS were treated with intravenous thrombolysis.According to whether HT occurred after intravenous thrombolysis,the patients were divided into HT group(n=67)and non-HT group(n=362).Enzyme-linked immunosorbent assay was used to detect the levels of serum FSTL1 and USF2 in the two groups before intravenous thrombolysis.The gender,age,body mass index,past medical history,smoking history,drinking his-tory,National Institutes of Health Stroke Scale(NIHSS)score before thrombolysis,time from onset to thrombolysis(ONT),baseline systolic blood pressure,baseline diastolic blood pressure,triglyceride,total cholesterol,uric acid,urea nitrogen,serum creatinine,white blood cell count,neutrophil count and other baseline data and laboratory examination in-dicators were collected and compared between the two groups.Logistic stepwise regression analysis was used to analyze the influencing factors of HT in AIS patients after intravenous thrombolysis with statistically significant indicators in univariate analysis as independent variables and assigned values.The receiver operating characteristic(ROC)curve was used to ana-lyze the predictive efficacy of serum FSTL1 and USF2 levels before intravenous thrombolysis on HT in AIS patients after in-travenous thrombolysis.Results The levels of serum FSTL1 and USF2 in HT group before intravenous thrombolysis were higher than those in non-HT group(all P<0.05).The age,body mass index,proportion of previous atrial fibrillation,uric acid level and NIHSS score before thrombolysis in the HT group were higher than those in the non-HT group(all P<0.05).Logistic regression analysis showed that high NIHSS score before thrombolysis(OR=2.353,95%CI:1.305-4.246),high serum FSTL1 level before intravenous thrombolysis(OR=1.702,95%CI:1.093-2.651),and high se-rum USF2 level before intravenous thrombolysis(OR=1.640,95%CI:1.113-2.418)were risk factors for HT in AIS pa-tients after intravenous thrombolysis(all P<0.05).The area under the curve of serum FSTL1 level before intravenous thrombolysis in predicting HT in AIS patients after intravenous thrombolysis was 0.829(0.790-0.863).When the cut-off value was 39.42 ng/mL,the sensitivity was 82.09%and the specificity was 85.08%.The area under the curve of se-rum USF2 level before intravenous thrombolysis in predicting HT in AIS patients after intravenous thrombolysis was 0.809(0.769-0.845).When the cut-off value was 41.06 ng/mL,the sensitivity was 79.10%and the specificity was 85.91%.The area under the curve of serum FSTL1 and USF2 levels before intravenous thrombolysis in predicting HT in AIS patients after intravenous thrombolysis was 0.898(0.865-0.925),the sensitivity was 97.01%and the specificity was 84.25%.Conclusions Elevated serum FSTL1 and USF2 levels before intravenous thrombolysis are risk factors for HT in AIS patients after intravenous thrombolysis.Detection of serum FSTL1 and USF2 levels before intravenous thrombol-ysis can be used to predict HT in AIS patients after intravenous thrombolysis.
Keywords：acute ischemic strokeintravenous thrombolysishemorrhagic transformationfollistatin-like protein 1upstream stimulating factor-2
Publication Date：2025-03-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 83-87 )