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Chinese Journal of Clinicians(Electronic Edition) ›› 2022, Vol. 16 ›› Issue (03): 258-263. doi: 10.3877/cma.j.issn.1674-0785.2022.03.012

• Clinical Research • Previous Articles     Next Articles

Predictive value of serum Netrin-1 and NSE for early neurological deterioration and prognosis of acute ischemic stroke

Bing Sun1, Yasuo Ding1,(), Chun Yin1, Zehao Liu1, Hao Chang1   

  1. 1. Department of Neurosurgery, Taizhou People's Hospital, Taizhou 225300, China
  • Received:2021-07-27 Online:2022-03-15 Published:2022-06-21
  • Contact: Yasuo Ding

Abstract:

Objective

To investigate the effect of serum neurite outgrowth guiding factor-1 (Netrin-1) and serum neuron-specific enolase (NSE) on early neurological deterioration in acute ischemic stroke and their predictive value for prognosis.

Methods

The data of 190 patients with acute ischemic stroke diagnosed and treated at Taizhou People's Hospital from August 2018 to December 2020 were retrospectively collected. According to the presence of early neurological deterioration or note, they were divided into a deterioration group (32 cases) or a non-deterioration group (158 cases). Univariate analysis and optimal Scaling regression were used to explore the influencing factors of early neurological deterioration. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of each index for early neurological deterioration in patients with acute ischemic stroke. According to the prognosis, the patients were divided into either a death group (24 cases) or a survival group (166 cases). NIHSS score and Netrin-1 and NSE levels were were compared between patients with different prognosis, and COX regression model was used to analyze the influencing factors of prognosis in patients with acute ischemic stroke.

Results

There were statistically significant differences in diabetes, hypertension, history of stroke, systolic blood pressure, diastolic blood pressure, NIHSS score, and Netrin-1 and NSE levels between the deterioration group and the non-deterioration group (P<0.05). Optimal Scaling regression showed that diabetes mellitus, hypertension, age, diastolic blood pressure, NIHSS score, Netrin-1, and NSE were risk factors for early neurological deterioration of acute ischemic stroke (P<0.05). ROC curve analysis showed that the AUC values of NIHSS score, Netrin-1, and NSE in predicting early neurological deterioration were 0.978, 0.993, and 0.989, respectively. There were statistically significant differences in NIHSS score and Netrin-1 and NSE levels between the survival group and death group (P<0.05). COX regression analysis showed that NSE and age were the influencing factors for the prognosis of acute ischemic stroke (P<0.05).

Conclusion

Netrin-1 and NSE levels are effective indicators of early neurological deterioration and prognosis of acute ischemic stroke, with high diagnostic efficacy.

Key words: Early neural function, Neuron-specific enolase, Neural guidance factor

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