He Si-Si, Huang Xiang-Dong, Zhang Shi-Zheng, Zhuang Qing-Qing, Chen Xin-Xin, Wang Hao-Dong, Mao Xin-Lei
Department of Neurology, The Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, 252 Bailidong Road, Wenzhou, 325000, China.
Panvascular Disease Management Center, The Wenzhou Central Hospital, 252 Bailidong Road, Wenzhou, 325000, China.
Sci Rep. 2025 Apr 23;15(1):14197. doi: 10.1038/s41598-025-92732-z.
Platelet-derived microparticles (PDMPs) participate in ischemic brain injury. We further determined the relationships between serum PDMPs levels and early neurological deterioration (END) as well as functional outcome after acute cerebral infarction (ACI). In this prospective cohort study, serum PDMPs levels were measured in 125 controls and 621 patients with ACI. Univariate analysis and multivariate analysis were sequentially applied to investigate the relations of serum PDMPs levels to END and poor prognosis (modified Rankin scale score > 2) at six months after ACI. Serum PDMPs levels were significantly higher in patients than in controls (median, 14.00 ng/L vs. 27.00 ng/L; P < 0.001). Serum PDMPs levels were strongly correlated with infarction volume (ρ = 0.532, P < 0.001), National Institutes of Health Stroke Scale score (ρ = 0.627, P < 0.001) and modified Rankin scale score (ρ = 0.528, P < 0.001). It was independently associated with END [odds ratio (OR) 1.117, 95% confidence interval (CI) 1.008-1.238; P = 0.001] and poor prognosis (OR 1.092, 95% CI 1.066-1.119; P = 0.001). There were linear relationships between serum PDMPs levels and risks of poor prognosis (P for non-linear = 0.055) plus END (P for non-linear = 0.061) under restricted cubic spline. Using subgroup analysis, significant interaction existed between serum PDMPs levels and age in association of poor prognosis (P for interaction = 0.006), as well as between serum PDMPs levels and coronary heart disease in association of END (P for interaction = 0.017). Serum PDMPs levels significantly discriminated the development of poor prognosis (Area under curve 0.705, 95% CI 0.632-0.778; P < 0.001) and END (The area 0.733, 95% CI 0.664-0.803; P < 0.001). Serum PDMPs levels may predict the risk of END and 6-month poor prognosis in patients with ACI.
血小板衍生微粒（PDMPs）参与缺血性脑损伤。我们进一步确定了急性脑梗死（ACI）后血清PDMPs水平与早期神经功能恶化（END）以及功能结局之间的关系。在这项前瞻性队列研究中，测定了125名对照者和621例ACI患者的血清PDMPs水平。依次应用单因素分析和多因素分析来研究血清PDMPs水平与ACI后6个月时END和预后不良（改良Rankin量表评分>2）之间的关系。患者的血清PDMPs水平显著高于对照者（中位数，14.00 ng/L对27.00 ng/L；P<0.001）。血清PDMPs水平与梗死体积（ρ=0.532，P<0.001）、美国国立卫生研究院卒中量表评分（ρ=0.627，P<0.001）和改良Rankin量表评分（ρ=0.528，P<0.001）密切相关。它与END独立相关[比值比（OR）1.117，95%置信区间（CI）1.008 - 1.238；P = 0.001]以及预后不良（OR 1.092，95% CI 1.066 - 1.119；P = 0.001）。在受限立方样条分析下，血清PDMPs水平与预后不良风险（非线性P=0.055）以及END风险（非线性P=0.061）之间存在线性关系。通过亚组分析，血清PDMPs水平与年龄在预后不良关联方面存在显著交互作用（交互作用P=0.006），以及血清PDMPs水平与冠心病在END关联方面存在显著交互作用（交互作用P=0.017）。血清PDMPs水平显著区分了预后不良的发生（曲线下面积0.705，95% CI 0.632 - 0.778；P<0.001）和END（面积0.733，95% CI 0.664 - 0.803；P<0.001）。血清PDMPs水平可能预测ACI患者END的风险和6个月时的预后不良。
