Correlation between serum long-chain acyl-CoA synthetase 4 and inter-alpha-trypsin inhibitor heavy chain 4 levels with neurological deficit severity and prognosis in patients with acute intracerebral hemorrhage
Zhou Ran
Yin Yue
Li Jing
Zhang Xiaolei
Li Meng
Wang Shizhao
Abstract：Objective To investigate the correlation between serum long-chain acyl-CoA synthetase 4(ACSL4)and inter-alpha-trypsin inhibitor heavy chain 4(ITIH4)levels with neurological deficit severity and prognosis in patients with acute intracerebral hemorrhage(ICH).Methods A total of 200 ICH patients admitted to North China University of Science and Technology Affiliated Hospital from January 2020 to June 2024 were retro-spectively enrolled as the ICH group,and 150 healthy subjects who underwent physical examination during the same period were selected as the control group.According to the National Institutes of Health Stroke Scale(NIHSS)score at admission,ICH patients were divided into the mild group(36 cases),moderate group(90 cases)and severe group(74 cases).According to the modified Rankin Scale(mRS)score during follow-up,ICH patients were divided into the good prognosis group(131 cases)and poor prognosis group(69 cases).The differences in serum ACSL4 and ITIH4 levels among the above subgroups were compared.Pearson correlation analysis was used to analyze the correlation between serum ACSL4,ITIH4 levels and NIHSS,mRS scores.Multivariate Logistic regression model was used to analyze the influencing factors for poor prognosis in ICH patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum ACSL4,ITIH4 levels and their combination for the prognosis of ICH patients.Results The serum ACSL4 level in the ICH group was significantly higher than that in the control group,while the serum ITIH4 level was significantly lower than that in the control group(both P＜0.05).With the aggravation of neurological deficit in ICH patients,the serum ACSL4 level showed a gradient increase,while the serum ITIH4 level showed a gradient decrease(all P＜0.05).The serum ACSL4 level in the poor prognosis group was significantly higher than that in the good prognosis group,while the serum ITIH4 level was significantly lower than that in the good prognosis group(both P＜0.05).The NIHSS score and mRS score at admission in the poor prognosis group were significantly higher than those in the good prognosis group(all P＜0.05).Serum ACSL4 level was positively correlated with NIHSS score and mRS score(r=0.428,0.438,both P＜0.001),while serum ITIH4 level was negatively correlated with NIHSS score and mRS score(r=-0.512,-0.455,both P＜0.001).Multivariate Logistic regression analysis showed that NIHSS score,mRS score,serum ACSL4 level and serum ITIH4 level were all influencing factors for the prognosis of ICH patients(all P＜0.05).ROC curve analysis showed that the areas under the curve(AUC)of ACSL4 and ITIH4 alone for predicting poor prognosis in ICH patients were 0.753 and 0.825 respectively,and the AUC of their combination was increased to 0.874,which was superior to that of single index prediction(both P＜0.05).Conclusion The serum ACSL4 level is abnormally increased and the serum ITIH4 level is abnormally decreased in ICH patients,both of which are closely related to the severity of neurological deficit.The combination of the two has a good predictive value for the prognosis of ICH patients.
Keywords：Acute intracerebral hemorrhageNeurological deficitLong-chain acyl-CoA synthetase 4Inter-alpha-trypsin inhibitor heavy chain 4
Publication Date：2026-03-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 371-375 )