血清HMGA2、P-gp与老年进展性脑梗死患者预后相关研究OACSTPCD

Objective To investigate the expression levels of serumhigh mobility group protein A2(HMGA2)and P-glycoprotein(P-gp)in elderly patients with progressive cerebral infarction and their relationship with prognosis.Methods A total of 67 elderly patients with progressive cerebral infarction and 79 elderly patients with non-progressive cerebral in-farction admitted to the Department of Neurology of Dalian Central Hospital from February 2020 to February 2023 were se-lected as the progressive group and the non-progressive group,respectively.According to the neurological recovery at 3 months after treatment,the progressive group was divided into good prognosis subgroup(n=39,mRS Score 0-2)and poor prognosis subgroup(n=28,mRS Score 3-6).Serum HMGA2 and P-gp levels were detected by enzyme-linked immu-nosorbent assay.Pearson product-moment correlation analysis was used to analyze the relationship between serum HMGA2,P-gp and NIHSS score.Logistic regression analysis was used to analyze the influencing factors of poor prognosis in patients with progressive cerebral infarction.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum HMGA2 and P-gp forpoorprognosis.Results The levels of serum HMGA2 and P-gp and NIHSS score in the progression group were higher than those in the non-progression group(t/P=13.672/<0.001,8.095/<0.001,8.226/<0.001).The serum levels of HMGA2 and P-gp were positively correlated with NIHSS score in patients with progres-sive cerebral infarction(r/P=0.732/<0.001,0.708/<0.001).The patients in the poor prognosis subgroup were older than those in the good prognosis subgroup,and the serum HMGA2 and P-gp levels and NIHSS condition were higher than those in the good prognosis subgroup(t/P=5.092/<0.001,5.103/<0.001,4.449/<0.001,2.357/0.021).Multivariate logistic regression a-nalysis showed that,advanced age,elevated serum HMGA2,P-gp levels and NIHSS score were independent risk factors for poor prognosis in patients with progressive cerebral infarction[OR(95%CI)=1.429(1.093-1.869),1.288(1.082-1.533);1.586(1.161-2.165),1.483(1.120-1.963)];The AUC of serum HMGA2,P-gp and their combination in predicting poor prognosis of patients with progressive cerebral infarction were 0.738,0.740 and 0.895,respectively,and the combination of HMGA2 and P-gp was better than each of them alone(Z=2.031,2.006,P=0.002,0.003).Conclusion Serum HMGA2 and P-gp levels are abnor-mally elevated in elderly patients with progressive cerebral infarction,and are related to the severity of the disease and poor prognosis.Early combined detection of the two indicators can predict the risk of poor prognosis in patients,so as to provide reference for clinical diagnosis and treatment.