Analysis of the Relationship Between Serum Homocysteine,Lp-PLA2,PTX3,and CXCL4 Levels in Patients with Cerebral Infarction and Early Neurological Deterioration Following Thrombolysis

SU Yawang

doi:10.14033/j.cnki.cfmr.2025.30.001

Abstract：Objective:To analyze the relationship between serum levels of CXC chemokine ligand 4(CXCL4),pentraxin 3(PTX3),lipoprotein-associated phospholipase A2(Lp-PLA2),and homocysteine(Hcy)in patients with cerebral infarction and early neurological deterioration following thrombolysis.Method:A total of 148 patients with cerebral infarction admitted to Quanzhou Hospital of Traditional Chinese Medicine between January 2021 and September 2024 were enrolled in this study.Patients were categorized into a deterioration group[National Institutes of Health Stroke Scale(NIHSS)score increase≥4 points compared to admission,n=44]and a non-deterioration group(NIHSS score increase<4 points compared to admission,n=104)based on whether neurological deterioration occurred within 24 hours post-thrombolysis.Serum homocysteine(Hcy),lipoprotein-associated phospholipase A2(Lp-PLA2),pentraxin(PTX3),and chemokine CXCL4 levels were measured at admission and 24 hours after thrombolysis.Neurological function scores were assessed.Laboratory parameter levels were compared between the two groups,and the relationship between serum CXCL4,PTX3,Lp-PLA2,and Hcy levels and early neurological deterioration was analyzed.Result:44 experienced neurological deterioration within 24 h after thrombolysis,accounting for 27.73%.At 24 h post-thrombolysis,the NIHSS scores in the deterioration group were higher than at admission and significantly higher than those in the non-deterioration group,with statistically significant difference(P<0.05).At admission,the levels of Hcy,Lp-PLA2,PTX3,and CXCL4 were significantly higher in the deterioration group than in the non-deterioration group,with statistically significant difference(P<0.05).Serum Hcy,Lp-PLA2,PTX3,and CXCL4 levels in patients with cerebral infarction showed a positive correlation with neurological function scores,with statistically significant difference(P<0.05).Serum Lp-PLA2 demonstrated the highest predictive efficacy for early neurological deterioration in patients with cerebral infarction,with statistically significant difference(P<0.05).At the maximum Yorden index,the corresponding cutoff value was 156.36 μg/L,yielding an area under the curve of 0.899,a sensitivity of 79.52%,and a specificity of 82.71%.Conclusion:Serum homocysteine(Hcy),lipoprotein-associated phospholipase A2(Lp-PLA2),prostaglandin-15(PTX3),and chemokine CXCL4 levels in patients with cerebral infarction show significant correlations with changes in neurological function.Serum Lp-PLA2 demonstrates high predictive efficacy for early neurological deterioration.