Evaluation value of milk fat globulum-epidermal growth factor 8 and M1/M2 polarization levels of macrophages in peripheral blood in neurological impairment in stroke patients
10.3969/j.issn.1008-9691.2024.04.007
- VernacularTitle:外周血乳脂球表皮生长因子8和巨噬细胞M1/M2极化水平对脑卒中患者神经功能缺损的评估价值
- Author:
Wenwen ZHANG
1
;
Xiaoliang LI
;
Lina YAO
Author Information
1. 保定市第二中心医院血管外科,河北 保定 072750
- Keywords:
Stroke;
Milk fat globule-epidermal growth factor 8;
Macrophage;
Neurological deficit
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(4):423-427
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the significance of milk fat globule-epidermal growth factor 8(MFGE8)and the polarization of macrophage M1/M2 in peripheral blood for assessing neurological deficits in patients with stroke.Methods A total of 120 patients diagnosed with stroke in the Second Central Hospital of Baoding from January 2021 to December 2022 who did not die during the follow-up period were selected as the study subjects.They were divided into two groups based on the outcomes of their neurological function recovery:a favorable prognosis group(68 patients)and an unfavorable prognosis group(52 patients).The differences of blood biochemical indices,the concentrations of MFGE8 in peripheral blood,and the M1 to M2 macrophage ratio were compared in both groups;The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the extent of neurological damage;Multivariate Logistic regression was used to analyze the influencing factors of neurological function recovery in stroke patients and the predictive value of patient prognosis;Spearman correlation analysis was used to explore the correlation between MFGE8 and the degree of neurological function impairment in patients.Results The levels of MFGE8 and proportion of M2 macrophages in the favorable prognosis group were significantly higher than those in the unfavorable prognosis group[MFGE8(ng/L):1 587.69±389.28 vs.1 008.78±456.89,proportion of M2 macrophages:(6.54±1.28)%vs.(3.21±0.89)%,both P<0.05],conversely,the proportion of M1 macrophages in the favorable prognosis group was significantly lower than that in the unfavorable prognosis group[(2.32±0.36)%vs.(6.54±1.28)%,P<0.05].Multiple Logistic regression analysis identified age,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-CRP),levels of MFGE8,length of hospital stay,NIHSS score,and the M1/M2 macrophage ratio as independent risk factors for neurological function recovery in stroke patients[odds ratio(OR)and 95%confidence interval(95%CI)were 1.23(1.05-1.44),0.78(0.64-0.95),2.44(1.40-4.21),1.95(1.12-3.38),0.24(0.10-0.58),1.25(1.04-1.48),1.45(1.07-1.94),1.23(1.05-1.44),Pvalues were 0.01,0.01,0.00,0.02,0.00,0.02,0.01,0.00 respectively].Spearman correlation analysis demonstrated a significant negative correlation between MFGE8 levels and neurological deficits(r=-0.32,P=0.00),whereas the M1/M2 macrophage ratio was significantly positively correlated with neurological deficits(r=0.41,P=0.00).Receiver operator characteristic curve(ROC curve)analysis indicated that the MFGE8 level could predict poor prognosis in stroke patients with area under the curve(AUC)=0.797,95%CI was 0.718-0.876,P=0.000;the optimal cut-off value being 1 123.8 ng/L with a sensitivity of 79.4%and specificity of 69.2%.Conclusion MFGE8 levels and the polarization of M1/M2 macrophages in peripheral blood are crucial for evaluating and influencing the recovery of neurological deficits in stroke patients.
