Prognostic value of serum thrombospondin-1 combined with alberta stroke program early CT score in patients with acute large-vessel occlusive cerebral infarction

JIANG Hao; CHENG Kaili; CHEN Liu

doi:10.3969/j.issn.1006-5725.2025.16.018

Abstract：Objective To investigate the prognostic value of serum thrombospondin-1(THBS-1)combined with Alberta Stroke Program Early CT Score(ASPECTS)in patients with acute cerebral infarction with large vessel occlusion(ACI-LVO).Methods A total of 198 ACI-LVO patients admitted to the hospital from January 2022 to October 2024 were prospectively enrolled(ACI-LVO group).Patients were categorized into mild,moderate,and severe subgroups based on National Institutes of Health Stroke Scale(NIHSS)scores,and into good or poor prognosis groups based on 90-day outcomes.Serum THBS-1 levels were measured using ELISA,and ASPECTS scores were calculated.Spearman correlation analysis was used to assess the relationship between THBS-1,ASPECTS,and NIHSS scores.Prognostic factors and predictive values of THBS-1 and ASPECTS were also analyzed.Results Among the 198 patients,58 had mild,67 had moderate,and 73 had severe ACI-LVO.Serum THBS-1 levels increased,and ASPECTS scores decreased progressively with worsening disease severity(P<0.05).NIHSS scores were positively correlated with serum THBS-1 and negatively correlated with ASPECTS scores(P<0.05).The 90-day poor outcome rate was 37.37％(74/198).Independent risk factors for poor prognosis included older age,modified thrombolysis in cerebral infarction score of 0～2a,higher NIHSS score,larger infarct volume,hemorrhagic transformation,and elevated THBS-1.A higher ASPECTS score was an independent protective factor(P<0.05).The area under the curve(AUC)for predicting prognosis was 0.794 for THBS-1,0.831 for ASPECTS,and 0.903 for their combination,with the combined model showing superior predictive value(P<0.05).Conclusions Elevated serum THBS-1 and decreased ASPECTS scores are associated with increased disease severity and poorer prognosis in ACI-LVO patients.The combination of serum THBS-1 and ASPECTS score provides high predictive value for assessing prognosis in ACI-LVO patients.