To Study The Correlation Between Serum RIPK1,RIPK3 Levels And Disease Severity And Prognosis In Patients With Acute Ischemic Stroke

Objective: To investigate the correlation between serum RIPK1,RIPK3 and disease severity and prognosis in patients with Acute ischemic stroke(AIS)by detecting the levels of RIPK1 and RIPK3,evaluating brain function and cerebral infarction volume.The value of serum RIPK1 and RIPK3 levels in the severity and prognosis evaluation and prediction of the disease were evaluated.Methods: A total of 191 patients with acute ischemic stroke who met the inclusion criteria in the Affiliated Hospital of Youjiang Medical College for Nationalities from October2021 to October 2022 were collected,and 54 normal people who underwent routine physical examination in the outpatient department of our hospital during this period were selected as the control group.Fasting whole blood was collected on the second day of the study.RIPK1 and RIPK3 enzyme-linked immunosorbent assay kits were used to detect the serum levels of RIPK1 and RIPK3 in 245 patients and normal controls.The general information and infarct volume of patients in the AIS group were collected and recorded,and the National Institute of Health Stroke Scale(NIHSS)score was performed on admission.The patients were followed up for 90 days by telephone and return visit after discharge.According to the m RS Score of the patients and their families,they were divided into good prognosis group and poor prognosis group.SPSS26.0 statistical software was used to analyze the differences in serum RIPK1 and RIPK3 levels between the AIS group and the control group,under different infarct volumes and different degrees of neurological deficits,and the relationship between serum RIPK1 and RIPK3 levels and short-term prognosis in the AIS group.Results:(1)Serum RIPK1 and RIPK3 concentrations in AIS group were significantly higher than those in control group(P < 0.001).(2)The concentration levels of serum RIPK1 and RIPK3 in the large volume infarction group,the medium volume infarction group and the small volume infarction group decreased successively,and the significant P value of ANOVA was less than 0.05,the difference was statistically significant.(3)The mean concentrations of serum RIPK1 and RIPK3 in the severe group,moderate group and mild group with neurological impairment decreased successively,and the significant P values of variance analysis were all less than 0.001,the differences were statistically significant.(4)Analysis of general data of the good and bad prognosis groups showed that hypertension,degree of neurological impairment and infarct size may be risk factors for poor prognosis in AIS patients(P < 0.05).Serum concentrations of RIPK1 and RIPK3 in the good prognosis group were significantly lower than those in the poor prognosis group(P < 0.001).(5)The correlation coefficient between RIPK1 and RIPK3 was 0.3972(P < 0.001),and there was a positive correlation between RIPK1 and RIPK3.(6)The correlation coefficient between serum RIPK1 and neurological impairment score was 0.656(P < 0.001),and there was a positive correlation between serum RIPK1 and neurological impairment score.The correlation coefficient between serum RIPK3 and neurological impairment score was 0.6129(P < 0.001),and there was a positive correlation between serum RIPK3 and neurological impairment score.The correlation coefficient between serum RIPK1 and cerebral infarction volume was 0.5695(P < 0.001),and there was a positive correlation between serum RIPK1 and cerebral infarction volume.The correlation coefficient between serum RIPK3 and cerebral infarction volume was 0.6619(P < 0.001),and there was a positive correlation between serum RIPK3 and cerebral infarction volume.(7)Logistic regression analysis of prognostic factors of AIS showed that there was no significant difference between hypertension,neurological impairment,serum RIPK1 level and short-term prognosis of AIS(P > 0.05).The OR values of cerebral infarction volume,serum RIPK3 concentration level and poor prognosis in AIS patients were 9.398(P < 0.05)and 1.017(P < 0.05),respectively,which were risk factors for short-term prognosis in AIS patients.(8)According to ROC curve analysis,the optimal critical value of serum RIPK1 for predicting poor prognosis of AIS was47.84ng/m L,the sensitivity was 53.6%,and the specificity was 71.1%.The optimal threshold value of serum RIPK3 for predicting adverse prognosis of acute ischemic stroke was371.53pg/m L,the sensitivity was 64.3%,the specificity was 82.2%,and the area under the curve(AUC)was 0.649 and 0.774,respectively,with significance less than P < 0.001.Serum RIPK1 and RIPK3 were prognostic markers.Conclusions:(1)The serum levels of RIPK1 and RIPK3 were positively correlated with the degree of neurological deficit and infarct volume,that is,the higher the serum levels of RIPK1 and RIPK3,the more severe the degree of neurological deficit and the larger the infarct volume in AIS patients.Therefore,serum RIPK1 and RIPK3 levels may be one of the hematological indicators to evaluate the severity of AIS and reflect the infarct volume.(2)The serum levels of RIPK1 and RIPK3,hypertension,neurological deficit and infarct volume have certain predictive value for the short-term prognosis of AIS patients,among which RIPK3 has a higher predictive value for the short-term prognosis of AIS patients.