Plasma ADAMTS-7 level and its relationship with prognosis in patients with acute ischemic stroke

doi:10.3969/j.issn.1673-8640.2021.010.009

Abstract

Abstract:

Objective To investigate plasma a disintegrin and metalloprotease with thrombospondin motif-7（ADAMTS-7）level and its relationship with prognosis in patients with acute ischemic stroke（AIS）. Methods A total of 101 patients with AIS were enrolled. The level of plasma ADAMTS-7 was determined before treatment and on the 2nd,4th and 8th days after treatment. The general clinical data of all the patients were collected,and they were classified into good prognosis group and poor prognosis group according to the prognosis of patients. Receiver operating characteristic（ROC）curve was used to evaluate the efficiency of plasma ADAMTS-7 in evaluating the prognosis of patients with AIS. Logistic regression analysis was used to evaluate the risk factors of AIS prognosis. ROC curve,calibration curve and decision tree curve analysis were used to evaluate the clinical value of the prognostic evaluation model. Results There was statistical significance in age,fasting plasma glucose（FPG）,total cholesterol（TC）,the National Institute of Health Stroke Scale（NIHSS） score and onset-treatment time between good prognosis group and poor prognosis group（P<0.05）. There was no statistical significance between the 2 groups for the other items（P>0.05）. The plasma ADAMTS-7 levels in poor prognosis group on the 4th and 8th days of treatment were higher than those in good prognosis group（P<0.05）. The plasma ADAMTS-7 levels in poor prognosis group and good prognosis group showed a decreasing trend with treatment time prolonging,and the decrease degree of plasma ADAMTS-7 levels in poor prognosis group was lower than that in good prognosis group（P<0.05）. ROC curve analysis showed that the area under curve（AUC） of plasma ADAMTS-7 on the 8th day of treatment for evaluating the prognosis of AIS was 0.864,which was bigger than those before treatment（0.636）,on the 2nd day of treatment（0.572） and on the 4th day of treatment（0.660）（P<0.001）. Logistic multivariate regression analysis showed that FPG,NIHSS score,onset-treatment time and plasma ADAMTS-7 on the 8th day of treatment were risk factors for the prognosis of patients with AIS [odds ratios（OR） were 1.801,1.707,8.531 and 1.172,respectively]. ROC curve analysis showed that the AUC,optimal cut-off value,sensitivity and specificity of the prognostic evaluation model for evaluating the prognosis of patients with AIS were 0.963,0.72,96.43% and 91.78%,respectively. Conclusions The level of plasma ADAMTS-7 on the 8th day of treatment is closely related to the prognosis of patients with AIS. The prognostic evaluation model based on ADAMTS-7 on the 8th day of treatment plays a role in predicting the prognosis of AIS.

Key words: A disintegrin and metalloprotease with thrombospondin motif-7, Acute ischemic stroke, Prognosis

CLC Number:

R446.1

LI Jinyi, LI Chunlei, JIA Yonglin, JIA Dongpei. Plasma ADAMTS-7 level and its relationship with prognosis in patients with acute ischemic stroke[J]. Laboratory Medicine, 2021, 36(10): 1033-1038.

Figures/Tables 6

References 22

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组别	例数	年龄/岁	性别		BMI/（kg/m²）	吸烟史/例	高血压史/例
组别	例数	年龄/岁	男/例	女/例	BMI/（kg/m²）	吸烟史/例	高血压史/例
预后不良组	28	59.18±6.88	22	6	24.01±2.11	8	14
预后良好组	73	54.92±7.17	47	26	24.71±2.16	27	31
统计值		2.703	1.882		1.481	0.633	0.465
P值		0.008	0.170		0.142	0.426	0.495
组别		冠心病史/例	收缩压/kPa		舒张压/kPa	FPG/（mmol/L）	TC/（mmol/L）
预后不良组		5	19.76±2.39		10.88±1.55	9.52±2.42	4.90±0.87
预后良好组		10	19.54±1.73		10.72±1.19	7.24±1.74	4.08±0.85
统计值		0.046	0.461		0.556	4.540	4.305
P值		0.831	0.648		0.580	<0.001	<0.001
组别		TG/（mmol/L）	LDL-C/（mmol/L）		HDL-C/（mmol/L）	NIHSS评分/分	发病-治疗时间/h
预后不良组		1.62±0.41	2.83±0.56		1.30±0.29	12.25±3.15	3.08±0.55
预后良好组		1.80±0.52	2.73±0.65		1.23±0.24	9.27±1.95	2.81±0.47
统计值		1.576	0.660		1.242	4.674	2.479
P值		0.118	0.511		0.217	<0.001	0.015

组别	例数	年龄/岁	性别		BMI/（kg/m²）	吸烟史/例	高血压史/例
组别	例数	年龄/岁	男/例	女/例	BMI/（kg/m²）	吸烟史/例	高血压史/例
预后不良组	28	59.18±6.88	22	6	24.01±2.11	8	14
预后良好组	73	54.92±7.17	47	26	24.71±2.16	27	31
统计值		2.703	1.882		1.481	0.633	0.465
P值		0.008	0.170		0.142	0.426	0.495
组别		冠心病史/例	收缩压/kPa		舒张压/kPa	FPG/（mmol/L）	TC/（mmol/L）
预后不良组		5	19.76±2.39		10.88±1.55	9.52±2.42	4.90±0.87
预后良好组		10	19.54±1.73		10.72±1.19	7.24±1.74	4.08±0.85
统计值		0.046	0.461		0.556	4.540	4.305
P值		0.831	0.648		0.580	<0.001	<0.001
组别		TG/（mmol/L）	LDL-C/（mmol/L）		HDL-C/（mmol/L）	NIHSS评分/分	发病-治疗时间/h
预后不良组		1.62±0.41	2.83±0.56		1.30±0.29	12.25±3.15	3.08±0.55
预后良好组		1.80±0.52	2.73±0.65		1.23±0.24	9.27±1.95	2.81±0.47
统计值		1.576	0.660		1.242	4.674	2.479
P值		0.118	0.511		0.217	<0.001	0.015

组别	例数	治疗前ADAMTS-7/（ng/mL）	治疗第2天		治疗第4天
组别	例数	治疗前ADAMTS-7/（ng/mL）	ADAMTS-7/ （ng/mL）	较治疗前降低幅度/%	ADAMTS-7/ （ng/mL）	较治疗前降低幅度/%	较治疗第2天降低幅度/%
预后不良组	28	93.14±9.88	79.93±8.54^#	13.85±7.93	71.59±8.73^*#△	22.62±10.26	10.23±7.81
预后良好组	73	88.57±10.83	77.66±9.74^#	11.82±9.66	65.95±10.21^#△	24.51±14.48	13.97±15.83

组别	例数	治疗前ADAMTS-7/（ng/mL）	治疗第2天		治疗第4天
组别	例数	治疗前ADAMTS-7/（ng/mL）	ADAMTS-7/ （ng/mL）	较治疗前降低幅度/%	ADAMTS-7/ （ng/mL）	较治疗前降低幅度/%	较治疗第2天降低幅度/%
预后不良组	28	93.14±9.88	79.93±8.54^#	13.85±7.93	71.59±8.73^*#△	22.62±10.26	10.23±7.81
预后良好组	73	88.57±10.83	77.66±9.74^#	11.82±9.66	65.95±10.21^#△	24.51±14.48	13.97±15.83

时间点	AUC（95%可信区间）	最佳临界值/（ng/mL）	敏感性/%	特异性/%	约登指数
治疗前	0.636（0.518~0.754）	92.12	60.71	65.75	0.265
治疗第2天	0.572（0.449~0.695）	74.55	82.14	36.99	0.191
治疗第4天	0.660（0.546~0.774）	60.11	96.43	30.14	0.266
治疗第8天	0.864（0.792~0.937）	55.88	82.14	72.60	0.548