Observation of serum angiopoietin-2 and stress-induced protein 2 levels in patients with acute ischemic stroke after intravenous thrombolysis and their correlation with clinical prognosis

Yi Wei; Wang Fan; Luo Jiefeng

doi:10.3760/j.issn.1673-4777.2025.05.009

Abstract：Objective To observe serum angiopoietin-2(Ang-2)and stress-induced protein 2(Sesn2)levels in patients with acute ischemic stroke(AIS)after intravenous thrombolysis and their correlation with clinical prognosis.Methods A total of 105 AIS patients who received intravenous thrombolytic therapy in Baiyun Hospital Affiliated to Guizhou Medical University from August 2022 to March 2024 were prospectively selected.Serum Ang-2 and Sesn2 levels were measured at admission,and the prognosis was evaluated 3 months after thrombolysis.The levels of serum Ang-2 and Sesn2 in patients with different severity and prognosis were compared,and the relationship between serum Ang-2 and Sesn2 and the clinical prognosis of AIS patients was analyzed.Results The serum Ang-2 and Sesn2 in the severe group(30 cases)were higher than those in the moderate-severe group(46 cases)and the moderate group(29 cases)[(32±6)ng/L vs(29±5),(24±5)ng/L,(16±3)μg/L vs(12±4),(10±3)μg/L],and the moderate-severe group were higher than the moderate group(all P＜0.05).At 3 months after thrombolysis,45 of 105 patients had poor prognosis.The levels of serum Ang-2,Sesn2 and D-dimer and the proportion of patients with severe disease severity in the poor prognosis group were higher than those in the good prognosis group(all P＜0.05).Multivariate Logistic regression analysis showed that severe disease,D-dimer,Ang-2 and Sesn2 were independent prognostic factors(all P＜0.05).The restricted cubic spline analysis showed that the serum Ang-2 and Sesn2 levels were positively correlated with the prognosis of AIS patients in a non-linear dose-response relationship(both P＜0.05),and there was a positive interaction between serum Ang-2 and Sesn2 on the prognosis of AIS patients(the cut-off values were 28.18 ng/L and 12.61 μg/L,respectively).The nomogram showed that the concordance index of the model with serum Ang-2,Sesn2,D-dimer and disease severity was 0.975(95％confidence interval:0.951-0.999),and the discrimination was good.When the decision curve was drawn,the net earning rate of the decision curve drawn by serum Ang-2,Sesn2,and D-dimer level was higher,and the maximum net earning rate was 0.429.Conclusions The more severe the disease,the higher the serum Ang-2 and Sesn2 levels.When the serum Ang-2 and Sesn2 levels were higher than 28.18 ng/L and 12.61 μg/L respectively before treatment,the clinical prognosis might be poor and high risk.The serum Ang-2 and Sesn2 levels combined with disease severity and D-dimer levels can improve the predictive value for the clinical prognosis of AIS.