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Relationship between serum soluble triggering receptor expressed on myeloid cells-1 and the severity and prognosis of elderly patients with acute ischemic stroke
LIN Qiao-mao, LI Kuo, XIANG Ning, WANG Hai-yan
Practical Geriatrics
2022, 36 (8):
827-832.
DOI: 10.3969/j.issn.1003-9198.2022.08.018
Objective To investigate the relationship between the serum level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and the severity and prognosis of the elderly patients with acute ischemic stroke (AIS). Methods A total of 98 elderly patients with AIS were selected as the AIS group and were divided into a mild deficit group (n=28), a moderate deficit group (n=29) and a severe deficit group (n=41) according to the score of National Institutes of Health Stroke Scale (NIHSS) at admission, and were divided into a poor prognosis group (n=38) and a good prognosis group (n=60) according to the score of modified Rankin Scale (mRS) after 6 months. And another 45 elderly healthy individuals were selected as the control group during the same period. The serum levels of sTREM-1, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and S100B were measured by enzyme linked immunosorbent assay. Pearson or Spearman correlation was used to analyze the correlations of serum sTREM-1 with IL-6, TNF-α, S100B, NIHSS and mRS scores in AIS patients. The influencing factors of poor prognosis of AIS were analyzed by Logistic regression. The predictive value of sTREM-1 for poor prognosis was analyzed using receiver operator characteristic (ROC) curve. Results The serum levels of sTREM-1, IL-6, TNF-α and S100B were increased in the AIS group compared with the control group (all P＜0.01). The serum levels of sTREM-1, IL-6, TNF-α and S100B were sequentially increased in the mild, moderate and severe deficit groups (all P＜0.01). The serum level of sTREM-1 in the patients with AIS was positively correlated with the levels of IL-6, TNF-α, S100B and NIHSS, mRS scores (r=0.764, 0.816, 0.823, 0.733, 0.626, all P＜0.01). Single factor analysis showed that the level of serum HDL-C was lower, the levels of LDL-C, sTREM-1, IL-6, TNF-α, S100B and NIHSS score were higher,the time from onset to admission was longer in the poor prognosis group than those in the good prognosis group (all P<0.05). Multivariate Logistic regression analysis showed that IL-6 (OR=1.037, 95%CI: 1.004-1.071), TNF-α (OR=1.046, 95%CI: 1.018-1.074), S100B (OR=1.139, 95%CI: 1.035-1.254), NIHSS score (OR=1.347, 95%CI: 1.085-1.674), sTREM-1 (OR=2.172, 95%CI: 1.098-4.296) were the independent risk factors of poor prognosis in the elderly patients with AIS. The area under ROC curve, sensitivity and specificity of serum sTREM-1 level to predict poor prognosis in the patients with AIS were 0.816, 94.74% and 61.67% respectively. Conclusions The increase of serum sTREM-1 in the elderly AIS patients is closely related to the severity and prognosis of AIS, and can be used as a predictor for poor prognosis.
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