Zhu Yanrong, Fan Kui, Zhao Xujuan, Hou Kaiwen
Clinic of Physical Examination Center of the Outpatient, General Hospital of the Western Theater Command of the People's Liberation Army of China, Chengdu, China.
Balkan Med J. 2025 May 5;42(3):201-211. doi: 10.4274/balkanmedj.galenos.2025.2025-1-36.
Acute ischemic stroke (AIS) remains a leading cause of disability worldwide, placing a significant burden on patients' quality of life and healthcare systems. Pentraxin-3 (PTX-3), an inflammatory biomarker, may be associated with AIS prognosis; however, existing evidence is inconclusive.
To examine whether serum PTX-3 levels at admission are linked to the likelihood of poor functional outcomes in AIS patients.
Systematic review and meta-analysis.
A comprehensive search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases was conducted to identify studies evaluating PTX-3 levels in AIS patients. Eligible studies included those that measured PTX-3 within 48 h of admission and evaluated outcomes using the modified Rankin Scale, with scores > 2 defined as poor outcomes. A random-effects model was used to calculate pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs).
Ten cohort studies involving1202 AIS patients were included. Higher PTX-3 levels at admission were significantly associated with an increased risk of poor functional outcomes (OR, 2.06; 95% CI, 1.72-2.47; < 0.001), with no significant heterogeneity (I² = 0%). Meta-regression showed that using higher PTX-3 cutoff values reported stronger associations ( < 0.05). Subgroup analyses confirmed consistent associations across study designs, patient characteristics, and timing of outcome assessment. The association was more pronounced in studies using a PTX-3 cutoff ≥ 3.3 ng/mL compared to those with a cutoff < 3.3 ng/mL.
Elevated serum PTX-3 levels at admission may serve as a prognostic biomarker for poor functional outcomes in AIS. Differences in PTX-3 cutoff values and potential residual confounding should also be considered. Further multicenter studies involving diverse populations are necessary to confirm these results and establish PTX-3 as a reliable prognostic indicator in clinical practice.
急性缺血性卒中（AIS）仍是全球致残的主要原因，给患者的生活质量和医疗系统带来了沉重负担。炎症生物标志物五聚体-3（PTX-3）可能与AIS预后相关；然而，现有证据尚无定论。
探讨入院时血清PTX-3水平是否与AIS患者功能预后不良的可能性相关。
系统评价和荟萃分析。
全面检索PubMed、Embase、Web of Science、中国知网（CNKI）和万方数据库，以识别评估AIS患者PTX-3水平的研究。符合条件的研究包括那些在入院48小时内测量PTX-3并使用改良Rankin量表评估结局的研究，得分>2定义为预后不良。采用随机效应模型计算合并比值比（OR）和相应的95%置信区间（CI）。
纳入了10项队列研究，涉及1202例AIS患者。入院时较高的PTX-3水平与功能预后不良风险增加显著相关（OR，2.06；95%CI，1.72-2.47；P<0.001），无显著异质性（I²=0%）。Meta回归显示，使用较高的PTX-3临界值报告的关联更强（P<0.05）。亚组分析证实，在不同的研究设计、患者特征和结局评估时间方面，关联一致。与临界值<3.3 ng/mL的研究相比，在使用PTX-3临界值≥3.3 ng/mL的研究中，这种关联更为明显。
入院时血清PTX-3水平升高可能是AIS患者功能预后不良的预后生物标志物。还应考虑PTX-3临界值的差异和潜在的残余混杂因素。有必要开展涉及不同人群的进一步多中心研究，以证实这些结果，并将PTX-3确立为临床实践中可靠的预后指标。
