Predictive value of serum chemokines and their receptors in the risk of hyperacute phase hemorrhagic transformation after intravenous thrombolysis in patients with acute cerebral infarction

Liu Sumei; Zhang Panpan; Zhu Yafei

doi:10.11850/j.issn.1009-122X.2025.03.005

Abstract：Objective To investigate the predictive value of serum C-X-C motifchemokine ligand 1(CXCL1)and C-X-C chemokine receptor 2(CXCR2)in the risk of hyperacute phase hemorrhage transformation(HT)after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Methods Clinical data of 128 patients with ACI were analyzed retrospectively,and all the patients completed intravenous thrombolysis.According to whether HT occurred in the hyperacute phase after intravenous thrombolysis,the patients were divided into HT group(23 cases,17.97%)and non-HT group(105 cases,82.03%).The differences in serum CXCL1 and CXCR2 between the two groups at admission were compared.The relationship between both CXCL1 and CXCR2 and hyperacute HT after intravenous thrombolysis in ACI patients was tested by point-biserial correlation test.The receiver operator characteristic(ROC)curve was plotted to evaluate the predictive value of CXCL1 and CXCR2 on hyperacute HT after intravenous thrombolysis in ACI patients.The decision curve analysis(DCA)was performed to evaluate the clinical benefit of CXCL1 and CXCR2 in predicting hyperacute HT after intravenous thrombolysis in ACI patients.Results The CXCL1 and CXCR2 in the HT group were higher than those in the non-HT group(P<0.05).The point-biserial correlation analysis revealed positive correlations between both CXCL1 and CXCR2 and HT in the hyperacute phase after intravenous thrombolysis in ACI patients(r>0,P<0.05).The ROC curves showed that CXCL1 and CXCR2 alone and in combination had certain predictive value for HT in the hyperacute phase after intravenous thrombolysis in ACI patients,and the combined prediction had the highest predictive value(P<0.05).The DCA indicated that when the high-risk threshold ranged from 0 to 1,the net benefit was greater than 0,with a maximum net benefit rate of 0.18,indicating clinical significance.Within the threshold range of 0.2-0.5,the combined use of CXCL1 and CXCR2 for predicting hyperacute HT after intravenous thrombolysis in ACI patients yielded a higher net benefit rate compared to using either marker alone.Conclusions The occurrence of hyperacute HT after intravenous thrombolysis in ACI patients is related to the abnormal expression of serum CXCL1 and CXCR2 at admission,which can be used as biomarkers to predict HT,and the combined prediction efficiency is higher.