检验医学与临床2025，Vol.22Issue(9)：1241-1245,5.DOI:10.3969/j.issn.1672-9455.2025.09.017
溶栓前血清TLR4、Beclin-1、趋化素预测急性脑梗死患者静脉溶栓应答的临床价值研究
Study on clinical value of serum TLR4,Beclin-1 and chemerin in predicting intravenous thrombolysis response before thrombolysis in patients with acute cerebral infarction
摘要
Abstract
Objective To investigate the clinical value of serum Toll-like receptor 4(TLR4),autophagy-re-lated protein Beclin-1 and chemerin in predicting the intravenous thrombolysis response before thrombolysis in the patients with acute cerebral infarction(ACI).Methods A total of 133 ACI patients admitted and treated in this hospital from September 2021 to June 2023 were selected as the modeling set for conducting the pro-spective study and divided into the poor group and good group according to the intravenous thrombolytic re-sponse.The serum TLR4,Beclin-1 and chemerin levels before thrombolysis were compared between the two groups.The multivariate Logistic regression was used to analyze the influencing factors of poor response to in-travenous thrombolysis in ACI patients.The receiver operating characteristic(ROC)curve was drawn to ana-lyze the value of individual and combined prediction of serum TLR4,Beclin-1 and chemerin before thrombolys-is for poor response to intravenous thrombolysis in ACI patients.The other 68 patients with intravenous thrombolysis admitted and treated in this hospital from July 2023 to June 2024 were selected as the external validation set.The Kappa consistency test was used to analyze the consistency between the three items for pre-dicting the intravenous thrombolysis response and the clinical reality in order to conduct the external valida-tion on the 3-item combination prediction.Results The serum TLR4,Beclin-1 and chemerin levels before thrombolysis in the poor group of the modeling set were higher than those in the good group(P＜0.05).The multivariate Logistic regression analysis results showed that the increased levels of serum TLR4,Beclin-1 and chemerin before thrombolysis were the independent risk factors for poor response to intravenous thrombolysis in ACI patients(P＜0.05).The results of the ROC curve showed that the area under the curve(AUC)of ser-um TLR4,Beclin-1 and chemerin alone and combination before thrombolysis for predicting the poor response to intravenous thrombolysis in ACI patients were 0.786,0.750,0.754 and 0.922,respectively.AUC of the 3-i-tem combined prediction was greater than that of serum TLR4,Beclin-1 and chemerin alone for prediction(Z=2.220,2.962,3.324,P=0.026,0.003,0.001).The Kappa consistency test showed that the consistency between the combined prediction of the three items for the response to intravenous thrombolysis and the clini-cal reality was 91.18％,and Kappa=0.744(P＜0.001).Conclusion Serum TLR4,Beclin-1 and chemerin be-fore thrombolysis are related to the intravenous thrombolysis response in ACI patients,which could serve as the candidate factors for judging the intravenous thrombolysis response in ACI.When the three combination,the predictive value is further elevated,providing an objective reference for the early clinical prediction of thrombolysis response and treatment decisions in the patients.关键词
急性脑梗死/Toll样受体4/Beclin-1/趋化素/静脉溶栓应答/预测价值Key words
acute cerebral infarction/Toll-like receptor 4/Beclin-1/chemerin/response to intrave-nous thrombolysis/predictive value分类
医药卫生引用本文复制引用
王亮亮,任占云,吴恺迪,史路遥..溶栓前血清TLR4、Beclin-1、趋化素预测急性脑梗死患者静脉溶栓应答的临床价值研究[J].检验医学与临床,2025,22(9):1241-1245,5.基金项目
江苏省优势学科建设工程项目(YSHL2101-1031). （YSHL2101-1031）
