心脑血管病防治2026，Vol.26Issue(3)：11-15,5.DOI:10.3969/j.issn.1009-816x.2026.03.003
新型血栓标志物对轻中度急性缺血性脑卒中进展为进展性缺血性脑卒中的预测价值及决策曲线分析
Predictive value of novel thrombosis biomarkers for the progression from mild-to-moderate acute ischemic stroke to progressive ischemic stroke and decision curve analysis
摘要
Abstract
Objective To evaluate the early predictive efficacy of novel thrombosis biomarkers for the progression from mild-to-moderate acute ischemic stroke(AIS)to progressive ischemic stroke(PIS)and to validate their clinical application value.Methods A total of 150 patients with mild-to-moderate AIS admitted to Weifang People's Hospital from January 2022 to November 2024 were enrolled consecutively.Clinical data were collected,and the levels of novel thrombosis biomarkers,including thrombin-antithrombin complex(TAT),α2-plasmin inhibitor-plasmin complex(PIC),thrombomodulin(TM),and tissue plasminogen activator-inhibitor complex(t-PAI·C)were measured.PIS was diagnosed based on changes in neurological deficit symptoms within 72h of onset.Patients were divided into the PIS group(42 cases)and the non-PIS group(108 cases).Multivariate Logistic regression analysis was used to identify factors influencing the progression from mild-to-moderate AIS to PIS.The predictive efficacy of the novel thrombosis biomarkers for this progression was analyzed using receiver operating characteristic(ROC)curve.Decision curve analysis(DCA)was performed to evaluate the clinical net benefit at different threshold probabilities.Results The levels of low-density lipoprotein cholesterol(LDL-C),D-dimer,homocysteine(Hcy),PIC,TM,TAT,and t-PAIC were higher in the PIS group than those in the non-PIS group(P<0.05).Multivariate Logistic regression analysis identified PIC,TM,TAT,and t-PAI·C as independent influencing factors for the progression from mild-to-moderate AIS to PIS(OR=2.148,1.327,1.322,1.417;P<0.05).ROC curve analysis showed that the area under the curve(AUC)for predicting PIS in patients with mild-to-moderate AIS was 0.707 for PIC,0.730 for TM,0.717 for TAT,and 0.716 for t-PAI·C.The combination of all four biomarkers yielded an AUC of 0.880.DCA showed that when the high-risk threshold was 0.0-0.6,the net benefit rate was>0,indicating that the prediction result has clinical significance,and the net benefit rate was higher when the threshold was smaller.Within the threshold range of 0.1-0.8,the net benefit rate of combined prediction of progression from mild-to-moderate AIS to PIS by PIC,TM,TAT,and t-PAI·C was higher than that of any single indicator.Conclusion The novel thrombosis biomarkers PIC,TM,TAT,and t-PAI·C possess predictive value for the progression from mild-to-moderate AIS to PIS and may serve as potential biomarkers for the early screening of PIS.关键词
进展性缺血性脑卒中/新型血栓标志物/预测/决策曲线Key words
Progressive ischemic stroke/Novel thrombosis markers/Prediction/Decision curve引用本文复制引用
于淼,于凯,赵宇,刘昕东,郑艳华..新型血栓标志物对轻中度急性缺血性脑卒中进展为进展性缺血性脑卒中的预测价值及决策曲线分析[J].心脑血管病防治,2026,26(3):11-15,5.基金项目
山东省潍坊市科技发展计划项目(2022YX059) （2022YX059）
