Objective To investigate the correlation between the expression level of absent in melanoma 2 (AIM2) in serum and the severity of acute cerebral infarction (ACI), and to evaluate the value of AIM2 in predicting early neurological deterioration (END) after intravenous thrombolysis with alteplase in ACI patients.
Methods A total of 150 ACI patients were enrolled in ACI group, and another 30 healthy individuals physical examination were selected as control group. ACI patients were further divided into mild, moderate and severe groups according to the National Institutes of Health Stroke Scale (NIHSS) score at admission, and they were also divided into END and non-END groups based on the occurrence of END after intravenous thrombolysis. Clinical materials of ACI patients were collected; the expression level of serum AIM2 was measured by enzyme-linked immunosorbent assay (ELISA); the Logistic regression analysis was performed to identify the factors influencing END after intravenous thrombolysis in ACI patients; the receiver operating characteristic (ROC) curve was plotted to analyze the clinical performance of serum AIM2 expression level in predicting END after intravenous thrombolysis in ACI patients.
Results The serum AIM2 expression level in the ACI group and the control group was (58.29±5.97) and (36.81±3.03) ng/mL respectively, with a significant between-group difference (t=43.23, P < 0.05). The serum AIM2 expression level gradually increased in the mild, moderate and severe groups, with significant differences between each pair of groups (P < 0.01). The serum AIM2 expression level in ACI patients was positively correlated with the NIHSS score (r=0.941, P < 0.01). The NIHSS score, time from admission to thrombolysis, low-density lipoprotein cholesterol (LDL-C), C-reactive protein, and AIM2 level in the END group were significantly higher or longer than those in the non-END group (P < 0.05). The results of multivariate Logistic regression analysis showed that NIHSS score (OR=3.871, P < 0.001), time from admission to thrombolysis (OR=2.885, P=0.002), LDL-C (OR=3.118, P < 0.001) and AIM2 (OR=3.761, P < 0.001) were influencing factors for END after intravenous thrombolysis in ACI patients. ROC curve showed that the area under the curve (AUC) for predicting END after intravenous thrombolysis based on the serum AIM2 expression level at admission in ACI patients was 0.911; when the cut-off value of AIM2 was 66.56 ng/mL, the diagnostic sensitivity and specificity were 91.23% and 90.15%, respectively.
Conclusion The expression level of serum AIM2 is significantly increased in ACI patients, and AIM2 expression level has certain advantages in predicting END after intravenous thrombolysis in ACI patients.
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