The expression levels of serum OPN,IRAK4 and S1P in different types of acute ischemic stroke and their prognostic analysis
Zhu Jing
Lian Zongde
Chen Ming
Zhou Xinyan
Li Huamin
Huang Can
Abstract：Objective To investigate the expression levels of serum osteopontin(OPN),interleukin 1 receptor as-sociated kinase 4(IRAK4)and sphingosine 1 phosphate(S1P)in patients with different types of acute ischemic stroke and their relationship with modified Rankin scale score(mRS).Methods One hundred and fifty patients with acute ischemic stroke admitted to the Department of Neurology of Dongguan Songshan Lake Tungwah Hospital from January 2022 to De-cember 2023 were selected as the study group(n=150).According to the classification,they were divided into large artery atherosclerosis type(n=23),small artery occlusion type(n=52),cardiogenic embolism type(n=60),other etiological type(n=11)and unknown cause type(n=4).The level of S1P was detected by enzyme linked immunosorbent assay.The neu-rological deficit score(NIHSS)and mRS score were recorded.The expression levels of serum OPN,IRAK4 and S1P,and the levels of serum OPN,IRAK4 and S1P in patients with different types of acute ischemic stroke and NIHSS score were com-pared.Pearson correlation analysis was used to analyze the relationship between serum S1P expression level and NIHSS score.The expression levels of serum OPN,IRAK4 and S1P and NIHSS scores in patients with different prognosis(mRs score)were compared.Pearson correlation analysis was used to analyze the relationship between mRs score and serum OPN,IRAK4 and S1P;the predictive value of serum OPN,IRAK4 and S1P for the prognosis of patients with acute ischemic stroke was analyzed by receiver operating curve(ROC).Results Compared with the healthy control group,the serum lev-els of OPN,IRAK4 and S1P in the study group were increased(t/P=25.882/＜0.001,14.910/＜0.001,50.674/＜0.001);Except for the unexplained type,the levels of serum OPN,IRAK4 and S1P in the large artery atherosclerosis type were lower than those in the small artery occlusion type,cardiogenic embolism type and other etiological type(F/P=60344/＜0.001,17.798/＜0.001,67.339/＜0.001,124.678/＜0.001);Compared with the subgroup with good prognosis,the expression levels of serum OPN,IRAK4 and S1P and NIHSS score in the subgroup with poor prognosis were significantly higher(t/P=5.377/＜0.001,3.829/＜0.001,3285/＜0.001,4.805/＜0.001).The expression levels of serum OPN(r/P=0.459/0.009,0.493/＜0.001),IRAK4(r/P=0.423/0.017,0.479/＜0.001)and S1P(r/P=0.525/＜0.001,0.487/＜0.001)were positively correlated with NIHSS score and mRs score.The AUC of serum OPN,IRAK4,S1P and their combination in predicting the prognosis of patients with acute is-chemic stroke were 0.656,0.740,0.804 and 0.872,respectively.The AUC of the combined prediction of acute ischemic stroke was greater than that of OPN(Z=3237,P=0.001),IRAK4(Z=5.181,P=0.001)and S1P(Z=2.018,P=0.035)alone.Conclu-sion The levels of OPN,IRAK4 and S1P in patients with acute ischemic stroke are increased,and the levels of OPN,IRAK4 and S1P and NIHSS score in small artery occlusion type and cardiogenic embolism type of acute ischemic stroke are significantly higher than those in other types.The combined detection of serum OPN,IRAK4 and S1P has a high predictive value for the prognosis of patients with acute ischemic stroke.
Keywords：Acute ischemic strokeOsteopontinInterleukin 1 receptor associated kinase 4Sphingosine 1 phos-phateModified Rankin scale scoreNeurological deficit scorePrognosis
Publication Date：2024-09-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1043-1048 )