A study on the relationship of serum CBLL1 and MMP3 levels with hemorrhagic transformation and prognosis after intravenous thrombolysis in acute ischemic stroke patients

MU Xiaochun; JIN Hongwen; SHE Bixia

doi:10.3969/j.issn.1674-3806.2024.10.12

Abstract：Objective To explore the relationship of serum CBL proto-oncogene like 1(CBLL1)and matrix metalloproteinase 3(MMP3)levels with hemorrhagic transformation(HT)and prognosis after intravenous thrombolysis in acute ischemic stroke(AIS)patients.Methods A total of 264 AIS patients who received intravenous thrombolytic therapy in Third Hospital of Heilongjiang Province from January 2020 to December 2022 were recruited.According to the occurrence of HT after intravenous thrombolysis,the patients were divided into HT group(42 cases)and non-HT group(222 cases).The clinical data,the levels of serum CBLL1 and MMP3 before treatment and the prognosis 3 months after treatment were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of HT occurrence after intravenous thrombolysis in the AIS patients.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of serum CBLL1 and MMP3 levels in predicting the occurrence and prognosis of HT after intravenous thrombolysis in the AIS patients.Results Compared with those in the non-HT group,the National Institutes of Health Stroke Scale(NIHSS)scores,serum CBLL1 and MMP3 levels,and the incidence of adverse prognosis[modified Rankin Scale(mRS)≥3 points]in the HT group were high,and the differences were statistically significant(P＜0.05).The results of multivariate logistic regression analysis showed that relatively high NIHSS scores[OR(95％CI)=1.298(1.028-1.639)]and serum CBLL1[OR(95％CI)=1.320(1.023-1.704]and MMP3[OR(95％CI)=1.406(1.103-1.793]levels were independent risk factors for occurrence of HT after intravenous thrombolysis in the AIS patients(P＜0.05).The results of ROC curve analysis showed that the combined detection of serum CBLL1 and MMP3 levels could effectively predict the occurrence of HT after intravenous thrombolysis[AUC(95％CI)=0.936(0.892-0.965),P＜0.001]and the prognosis[AUC(95％CI)=0.941(0.901-0.985),P＜0.001]in the AIS patients.Conclusion The elevated serum CBLL1 and MMP3 levels in AIS patients are associated with the occurrence of HT and poor prognosis after intravenous thrombolysis,which helps clinicians identify the high-risk patients and give early interventions.