1.Correlation between serum CC motif chemokine ligand 23,α-melanocyte stimulating hormone levels and neurological dysfunction and prognosis in patients with acute cerebral hemorrhage
Lin WANG ; Fangsen SUN ; Jian HAN
Journal of Clinical Neurology 2025;38(4):262-267
Objective To analyze the correlation between serum levels of CC motif chemokine ligand 23(CCL23),α-melanocyte stimulating hormone(α-MSH)and neurological dysfunction and prognosis in patients with acute intracerebral hemorrhage(AICH).Methods Ninety-seven patients with AICH were selected as the AICH group,and based on the sample size estimation method and the 1∶1 matching principle,97 healthy people with normal medical checkups in our hospitals during the same period were selected as the healthy group.The AICH group was divided into severe injury subgroup(NIHSS score≥ 15),moderate injury subgroup(15>NIHSS score≥ 8),and mild injury subgroup(NIHSS score<8)based on NIHSS score.ELISA was applied to detect serum levels of CCL23 and α-MSH.The correlation between serum CCL23 and α-MSH levels and the degree of neurological damage was analyzed using Spearman correlation analysis.Factors influencing prognosis in AICH patients were analyzed using multivariate Logistic regression analysis(stepwise forward approach).The area under the curve(AUC)of serum CCL23,α-MSH combined to predict prognosis in AICH patients was obtained by plotting the ROC curve.Results Compared with those in the normal control group,the serum CCL23 level was significantly increased and the α-MSH level was significantly decreased in the AICH group(all P<0.001).Serum CCL23 levels decreased sequentially in the severe injury subgroup,moderate injury subgroup,and mild injury subgroup(all P<0.05),and serum α-MSH levels increased sequentially(all P<0.05).Compared with those in the good prognosis subgroup,serum CCL23 level and NIHSS score were significantly higher and α-MSH level was significantly lower in the poor prognosis group(P<0.05-0.01).Spearman's correlation analysis showed that serum CCL23 level was positively correlated with the degree of neurological damage(ρ=0.558,P<0.001),α-MSH level was negatively correlated with the degree of neurological damage(ρ=-0.507,P<0.001).Multiple Logistic regression analysis showed that CCL23 level and NIHSS score were risk factors affecting the prognosis of AICH patients(OR=5.334,95%CI:2.078-13.693,P=0.001;OR=3.205,95%CI:1.475-6.965,P=0.003),and α-MSH was the protective factor affecting the prognosis of patients with AICH(OR=0.319,95%CI:0.168-0.606,P<0.001).The AUC of serum CCL23 andα-MSH combined to predict the prognosis of AICH patients was 0.927(95%CI:0.878-0.977),and the AUC of CCL23 and α-MSH alone to predict the prognosis of AICH patients was 0.832(95%CI:0.746-0.919)and 0.809(95%CI:0.719-0.898).The combined predictive value of the two was higher than that of CCL23(Z=1.877,P=0.030)and α-MSH(Z=2.254,P=0.012)alone.Conclusions The serum CCL23 level in AICH patients is abnormally elevated,while the α-MSH level is abnormally reduced.The changes in both levels are closely related to the degree of neurological damage,and have certain predictive value for the prognosis of AICH patients.
2.Correlation between serum CC motif chemokine ligand 23,α-melanocyte stimulating hormone levels and neurological dysfunction and prognosis in patients with acute cerebral hemorrhage
Lin WANG ; Fangsen SUN ; Jian HAN
Journal of Clinical Neurology 2025;38(4):262-267
Objective To analyze the correlation between serum levels of CC motif chemokine ligand 23(CCL23),α-melanocyte stimulating hormone(α-MSH)and neurological dysfunction and prognosis in patients with acute intracerebral hemorrhage(AICH).Methods Ninety-seven patients with AICH were selected as the AICH group,and based on the sample size estimation method and the 1∶1 matching principle,97 healthy people with normal medical checkups in our hospitals during the same period were selected as the healthy group.The AICH group was divided into severe injury subgroup(NIHSS score≥ 15),moderate injury subgroup(15>NIHSS score≥ 8),and mild injury subgroup(NIHSS score<8)based on NIHSS score.ELISA was applied to detect serum levels of CCL23 and α-MSH.The correlation between serum CCL23 and α-MSH levels and the degree of neurological damage was analyzed using Spearman correlation analysis.Factors influencing prognosis in AICH patients were analyzed using multivariate Logistic regression analysis(stepwise forward approach).The area under the curve(AUC)of serum CCL23,α-MSH combined to predict prognosis in AICH patients was obtained by plotting the ROC curve.Results Compared with those in the normal control group,the serum CCL23 level was significantly increased and the α-MSH level was significantly decreased in the AICH group(all P<0.001).Serum CCL23 levels decreased sequentially in the severe injury subgroup,moderate injury subgroup,and mild injury subgroup(all P<0.05),and serum α-MSH levels increased sequentially(all P<0.05).Compared with those in the good prognosis subgroup,serum CCL23 level and NIHSS score were significantly higher and α-MSH level was significantly lower in the poor prognosis group(P<0.05-0.01).Spearman's correlation analysis showed that serum CCL23 level was positively correlated with the degree of neurological damage(ρ=0.558,P<0.001),α-MSH level was negatively correlated with the degree of neurological damage(ρ=-0.507,P<0.001).Multiple Logistic regression analysis showed that CCL23 level and NIHSS score were risk factors affecting the prognosis of AICH patients(OR=5.334,95%CI:2.078-13.693,P=0.001;OR=3.205,95%CI:1.475-6.965,P=0.003),and α-MSH was the protective factor affecting the prognosis of patients with AICH(OR=0.319,95%CI:0.168-0.606,P<0.001).The AUC of serum CCL23 andα-MSH combined to predict the prognosis of AICH patients was 0.927(95%CI:0.878-0.977),and the AUC of CCL23 and α-MSH alone to predict the prognosis of AICH patients was 0.832(95%CI:0.746-0.919)and 0.809(95%CI:0.719-0.898).The combined predictive value of the two was higher than that of CCL23(Z=1.877,P=0.030)and α-MSH(Z=2.254,P=0.012)alone.Conclusions The serum CCL23 level in AICH patients is abnormally elevated,while the α-MSH level is abnormally reduced.The changes in both levels are closely related to the degree of neurological damage,and have certain predictive value for the prognosis of AICH patients.

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