ZHANG Ye, ZHUANG Xueming, YU Dawei, XU Dongsheng, ZHANG Li, WANG Zhongxiang, WANG Shibo. Value of serum high mobility group box 1 combined with modified Edinburgh-Scandinavian Stroke Scale score in evaluating prognosis of acute ischemic stroke patients with intravenous thrombolysis[J]. Journal of Clinical Medicine in Practice, 2021, 25(3): 23-27. DOI: 10.7619/jcmp.20201140
Citation: ZHANG Ye, ZHUANG Xueming, YU Dawei, XU Dongsheng, ZHANG Li, WANG Zhongxiang, WANG Shibo. Value of serum high mobility group box 1 combined with modified Edinburgh-Scandinavian Stroke Scale score in evaluating prognosis of acute ischemic stroke patients with intravenous thrombolysis[J]. Journal of Clinical Medicine in Practice, 2021, 25(3): 23-27. DOI: 10.7619/jcmp.20201140

Value of serum high mobility group box 1 combined with modified Edinburgh-Scandinavian Stroke Scale score in evaluating prognosis of acute ischemic stroke patients with intravenous thrombolysis

More Information
  • Received Date: October 15, 2020
  • Available Online: March 03, 2021
  • Published Date: March 03, 2021
  •   Objective  To explore value of the serum high mobility group box 1 (HMGB1) combined with modified Edinburgh-Scandinavian Stroke Scale (MESSS) score in evaluating prognosis of acute ischemic stroke (AIS) patients with intravenous thrombolysis.
      Methods  A total of 150 patients with AIS were divided into mild group (n=85) and severe group (n=65) according to severity of the disease. Serum HMGB1, N-terminal pro-B-type natriuretic peptide (NT-proBNP), platelet (PLT), prothrombin time (PT), international normalized ratio (INR) and MESSS were compared between the two groups before and after treatment. Pearson linear analysis was used to evaluate the correlation between clinical indicators and score of National Institutes of Health Stroke Scale (NIHSS). The patients were followed up for 1 year. According to the score of modified Rankin Scale (mRS) score, AIS patients were divided into good prognosis group (n=108) and poor prognosis group (n=42), and clinical indicators were compared between two groups. Multivariate Logistic regression analysis was used to analyze the correlation between each index and prognosis. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of serum HMGB1 and MESSS for the prognosis of AIS patients.
      Results  The levels of HMGB1, NT-proBNP and MESSS in the severe group were significantly higher than those in the mild group before and after treatment (P < 0.05). Pearson correlation analysis showed that serum HMGB1, NT-proBNP and MESSS were positively correlated with NIHSS score (r=0.859, 0.702, 0.791, P=0.025, 0.047, 0.031). After one-year follow-up, the HMGB1 level and MESSS score in the poor prognosis group were significantly higher than those in the good prognosis group (P < 0.05). Multivariate Logistic regression analysis showed that serum HMGB1 and MESSS were risk factors for poor prognosis in AIS patients after one-year follow-up (OR=2.913, 2.887, P=0.029, 0.036). ROC curve analysis showed that the area under the curve (AUC) of HMGB1≤13.5 μg/L combined with MESSS≥25.5 in predicting poor prognosis of AIS patients was 0.819, P value was 0.028, the sensitivity was 82.6%, and the specificity was 88.4%.
      Conclusion  Combined detection of serum HMGB1 and MESSS can effectively evaluate the disease condition of AIS patients with intravenous thrombolysis, and has a high value in predicting short-term prognosis.
  • [1]
    KESHK WA, ZINELDEEN DH, EL-HENEEDY YA, et al. Thrombomodulin, alarmin signaling, and copeptin: cross-talk between obesity and acute ischemic stroke initiation and severity in Egyptians[J]. Neurol Sci, 2018, 39(6): 1093-1104. doi: 10.1007/s10072-018-3396-0
    [2]
    KIM N, LEE S, LEE J R, et al. Prognostic role of serum high mobility group box 1 concentration in cardiac surgery[J]. Sci Rep, 2020, 10(1): 6293-6299. doi: 10.1038/s41598-020-63051-2
    [3]
    YE Y, ZENG Z, JIN T, et al. The Role of High Mobility Group Box 1 in Ischemic Stroke[J]. Front Cell Neurosci, 2019, 13: 127-134. http://www.ncbi.nlm.nih.gov/pubmed/31001089
    [4]
    WU H, LI R, PEI LG, et al. Emerging Role of High Mobility Group Box-1 in Thrombosis-Related Diseases[J]. Cell Physiol Biochem, 2018, 47(4): 1319-1337. doi: 10.1159/000490818
    [5]
    KIM S W, LEE J K. Role of HMGB1 in the Interplay between NETosis and Thrombosis in Ischemic Stroke: A Review[J]. Cells, 2020, 9(8): E1794-E1803. doi: 10.3390/cells9081794
    [6]
    中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J]. 中华神经科杂志, 2015, 48(4): 258-273. doi: 10.3760/cma.j.issn.1006-7876.2015.04.003
    [7]
    XIA P, PAN Y, ZHANG F, et al. Pioglitazone Confers Neuroprotection Against Ischemia-Induced Pyroptosis due to its Inhibitory Effects on HMGB1/RAGE and Rac1/ROS Pathway by Activating PPAR-γ[J]. Cell Physiol Biochem, 2018, 45(6): 2351-2368. doi: 10.1159/000488183
    [8]
    ZHOU H, WANG N, XU L, et al. The efficacy of gastrodin in combination with folate and vitamin B12 on patients with epilepsy after stroke and its effect on HMGB1, IL-2 and IL-6 serum levels[J]. Exp Ther Med, 2017, 14(5): 4801-4806. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704265/
    [9]
    GURSES K M, KOCYIGIT D, YALCIN M U, et al. Platelet Toll-like receptor and its ligand HMGB1 expression is increased in the left atrium of atrial fibrillation patients[J]. Cytokine, 2018, 103: 50-56. doi: 10.1016/j.cyto.2017.12.007
    [10]
    FAMAKIN B M, TSYMBALYUK O, TSYMBALYUK N, et al. HMGB1 is a Potential Mediator of Astrocytic TLR4 Signaling Activation following Acute and Chronic Focal Cerebral Ischemia[J]. Neurol Res Int, 2020, 2020: 3929438. http://www.researchgate.net/publication/339408505_HMGB1_is_a_Potential_Mediator_of_Astrocytic_TLR4_Signaling_Activation_following_Acute_and_Chronic_Focal_Cerebral_Ischemia
    [11]
    KIM M, KIM G, HWANG D W, et al. Delivery of High Mobility Group Box-1 siRNA Using Brain-Targeting Exosomes for Ischemic Stroke Therapy[J]. J Biomed Nanotechnol, 2019, 15(12): 2401-2412. doi: 10.1166/jbn.2019.2866
    [12]
    KIM S W, LEE H, LEE H K, et al. Neutrophil extracellular trap induced by HMGB1 exacerbates damages in the ischemic brain[J]. Acta Neuropathol Commun, 2019, 7(1): 94-103. doi: 10.1186/s40478-019-0747-x
    [13]
    NISHIHIRO S, HISHIKAWA T, HIRAMATSU M, et al. High-Mobility Group Box-1-Induced Angiogenesis After Indirect Bypass Surgery in a Chronic Cerebral Hypoperfusion Model[J]. Neuromolecular Med, 2019, 21(4): 391-400. doi: 10.1007/s12017-019-08541-x
    [14]
    WANG F, JI S, WANG M, et al. HMGB1 promoted P-glycoprotein at the blood-brain barrier in MCAO rats via TLR4/NF-κB signaling pathway[J]. Eur J Pharmacol, 2020, 880: 173189. doi: 10.1016/j.ejphar.2020.173189
    [15]
    YAN S, FANG C, CAO L, et al. Protective effect of glycyrrhizic acid on cerebral ischemia/reperfusion injury via inhibiting HMGB1-mediated TLR4/NF-κB pathway[J]. Biotechnol Appl Biochem, 2019, 66(6): 1024-1030. doi: 10.1002/bab.1825
    [16]
    KIM I D, LEE H, KIM S W, et al. Alarmin HMGB1 induces systemic and brain inflammatory exacerbation in post-stroke infection rat model[J]. Cell Death Dis, 2018, 9(4): 426-433. doi: 10.1038/s41419-018-0438-8
    [17]
    LI M, CHEN S, SHI X, et al. Cell permeable HMGB1-binding heptamer peptide ameliorates neurovascular complications associated with thrombolytic therapy in rats with transient ischemic stroke[J]. J Neuroinflammation, 2018, 15(1): 237-244. doi: 10.1186/s12974-018-1267-5
    [18]
    LE K, MO S, LU X, et al. Association of circulating blood HMGB1 levels with ischemic stroke: a systematic review and meta-analysis[J]. Neurol Res, 2018, 40(11): 907-916. doi: 10.1080/01616412.2018.1497254
    [19]
    WANG J, JIANG Y, ZENG D, et al. Prognostic value of plasma HMGB1 in ischemic stroke patients with cerebral ischemia-reperfusion injury after intravenous thrombolysis[J]. J Stroke Cerebrovasc Dis, 2020, 29(9): 105055. doi: 10.1016/j.jstrokecerebrovasdis.2020.105055
    [20]
    SUN Y, HEI M, FANG Z, et al. High-Mobility Group Box 1 Contributes to Cerebral Cortex Injury in a Neonatal Hypoxic-Ischemic Rat Model by Regulating the Phenotypic Polarization of Microglia[J]. Front Cell Neurosci, 2019, 13: 506-513. doi: 10.3389/fncel.2019.00506
  • Cited by

    Periodical cited type(9)

    1. 马雪萍,王晓丽,阿里木江·司马义,徐桂萍. 腹股沟上髂筋膜阻滞复合全身麻醉对高龄髋关节置换患者术后谵妄发生的影响. 新疆医学. 2022(02): 131-134 .
    2. 张宏,李淑萍. 老年患者髋关节置换术后谵妄的发生现状及其相关影响因素分析. 长春中医药大学学报. 2022(10): 1155-1159 .
    3. 刘贵政,郑婷婷,杜斌. 老年髋部骨折患者术后谵妄发生现况及危险因素研究. 贵州医药. 2022(09): 1405-1406 .
    4. 王秀环,鲍乐乐,马漪洁,陈宁宁. 不同麻醉方法对老年髋关节置换患者术后谵妄发生的影响. 广州医科大学学报. 2021(02): 40-44 .
    5. 刘丹,杨万翔. 人文关怀护理对人工髋关节置换术后谵妄患者临床症状的影响. 中国当代医药. 2021(25): 270-272+276 .
    6. 陈立红,徐芙蓉,叶洁玉,许华亮. 高龄骨科髋关节置换术后患者发生谵妄的危险因素分析. 现代医学与健康研究电子杂志. 2021(23): 115-118 .
    7. 毛俊岚. 高龄患者髋关节置换术后谵妄1例的护理. 基层医学论坛. 2020(03): 420-421 .
    8. 欧玉琼,吴建颖,周嫦娥. 以临床路径为指导的谵妄管理对老年股骨头置换术后患者的影响. 护理实践与研究. 2020(02): 86-88 .
    9. 姜红卫. 骨科老年患者髋关节术后谵妄发生原因及疼痛干预护理进展. 系统医学. 2020(13): 196-198 .

    Other cited types(1)

Catalog

    Article views (321) PDF downloads (21) Cited by(10)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return