Clinical value analysis of levels of serum hBD-2,Periostin,and TSP-1 in the diagnosis and prognosis evaluation of acute stroke complicated with pulmonary infection

Li Jie; Hu Biao; Li Ruili; Mi Jiuyun; Zhou Zhigang

doi:10.3969/j.issn.1671-6450.2025.04.010

Abstract：Objective To investigate the clinical value of serum levels of human beta-defens in-2(hBD-2),Periostin,and thrombospondin-1(TSP-1)in the diagnosis and prognosis evaluation of acute stroke(AS)complicated with pulmonary infection.Methods A total of 102 AS patients with lung infection admitted to the Respiratory and Critical Care Department of Xi'an Ninth Hospital from September 2021 to September 2023 were selected AS the infection group,and another 102 AS patients without lung infection during the same period were selected as the non-infection group.Enzyme linked immunosor-bent assay was applied to detect serum levels of hBD-2,Periostin,and TSP-1.ROC curve was applied to evaluate the diag-nostic value of serum hBD-2,Periostin,and TSP-1 for AS complicated with pulmnonary infection,and their predictive value for prognosis.Logistic regression analysis was applied to analyze the influencing factors of pulmonary infection in AS pa-tients.Results The proportion of patients underwent invasive procedures with dysphagia,and the levels of serum hBD-2,Periostin,TSP-1 in the infection group were higher than those in non-infection group(t/P=10242/＜0.001,4.819/＜0.001,12.246/＜0.001).The levels of serum hBD-2,Periostin and TSP-1 in the poor prognosis subgroup were higher than those in the good prognosis subgroup(t/P=4.335/＜0.001,6.571/＜0.001,5.441/＜0.001).Invasive operation,dysphagia,high hBD-2,high Periostin,and high TSP-1 levels were all influencing factors of AS combined with pulmonary infection[OR(95％ CI)=2.839(1.501-5.368),3.229(1.557-6.695).4.209(1.886-9.494),3.823(1.592-9.181),3.924(1.915-8.040)].The AUC of serum hBD-2,Periostin,TSP-1 and their combination in predicting AS with pulmonary infection were 0.735,0.782,0.781,and 0.878,and the AUC of the combined use of the three markers was larger than that of the individual prediction(Z/P=2.788/0.005,2.807/0.005,2.049/0.040).The AUC of serum hBD-2,Periostin,TSP-1,and their combined use in predicting the prognosis of pulmo-nary infection in AS were 0.790,0.785,0.782,and 0.861,and the AUC of the combined use of the three markers was not sig-nificantly different from those ofhBD-2,Periostin,and TSP-1 used alone(Z/P=1258/0209,1.580/0.114,1.416/0.157).Conclu-sion The serum levels of hBD-2,Periostin,and TSP-1 are high in patients with AS complicated with pulmonary infection,which are closely related to prognosis.Moreover,the combined diagnosis of these three factors has high clinical value in the diagnosis of AS complicated with pulmonary infection.