Abstract: Objective To investigate the predictive value of combined detection of serum complement C1q tumor necrosis factor-related protein 3 (CTRP-3), matrix metalloproteinase-9 (MMP-9), and tumor necrosis factor receptor-associated factor 6 (TRAF6) levels for hemorrhagic transformation (HT) after thrombolysis in patients with acute cerebral infarction. Methods A total of 107 patients with acute cerebral infarction admitted to the First People's Hospital of Nanyang City from January 2021 to January 2024 were selected. They were divided into the HT group (22 cases) and the non-HT group (85 cases) based on whether HT occurred within 24 hours after thrombolysis. The levels of serum CTRP-3, MMP-9, and TRAF6, as well as the National Institutes of Health Stroke Scale (NIHSS) scores, were compared between the two groups at admission, and their correlation was analyzed. The predictive value of combined serum indicators detection for HT occurrence after thrombolysis and the incidence of HT in patients with different serum levels after thrombolysis were also analyzed. Results Compared with the non-HT group, the HT group had lower serum CTRP-3 levels, higher serum MMP-9, TRAF6 levels, and NIHSS scores, with statistically significant differences (P<0.05). Serum CTRP-3 levels were negatively correlated with NIHSS scores, while serum MMP-9 and TRAF6 levels were positively correlated with NIHSS scores, with statistically significant differences (P<0.05). The area under the curve (AUC) for the combined prediction of post-thrombolysis HT using serum CTRP-3, MMP-9, and TRAF6 levels was 0.934, with a Youden's index of 0.744, and sensitivity and specificity of 90.91% and 83.53%, respectively, with statistically significant differences (P<0.05). The risk of post-thrombolysis HT in patients with high levels of serum CTRP-3, MMP-9, and TRAF6 was 0.113 times, 12.487 times, and 8.172 times than that in patients with low levels, respectively, with statistically significant differences (P<0.05). Conclusion The levels of serum CTRP-3, MMP-9, and TRAF6 are associated with the occurrence of HT after thrombolysis in patients with acute cerebral infarction. Combined detection of these three factors can provide a reference for clinical prediction of HT after thrombolysis in patients with acute cerebral infarction.

Key words: CTRP-3, MMP-9, TRAF6, Acute cerebral infarction, Hemorrhagic transformation

摘要： 目的 探讨血清补体C1q肿瘤坏死因子相关蛋白3（CTRP-3）、基质蛋白金属酶-9（MMP-9）、肿瘤坏死因子受体相关因子（TRAF6）水平联合检测对急性脑梗死患者溶栓后出血转化（HT）的预测价值。方法 选取南阳市第一人民医院2021年1月~2024年1月收治的107例急性脑梗死患者,依据溶栓后24 h是否发生HT分为HT组（22例）、非HT组（85例）。比较2组入院时血清CTRP-3、MMP-9、TRAF6水平、美国国立卫生研究院卒中量表（NIHSS）评分并分析相关性,分析血清指标联合检测对溶栓后发生HT的预测价值及不同血清水平患者溶栓后发生HT的情况。结果 与非HT组相比,HT组血清CTRP-3水平较低,血清MMP-9、TRAF6水平、NIHSS评分较高,差异有统计学意义（P<0.05）;血清CTRP-3水平与NIHSS评分呈负相关,血清MMP-9、TRAF6水平与NIHSS评分呈正相关,差异有统计学意义（P<0.05）;血清CTRP-3、MMP-9、TRAF6水平联合预测溶栓后HT的曲线下面积（AUC）为0.934,约登指数为0.744,敏感度、特异度分别为90.91%、83.53%,差异有统计学意义（P<0.05）;血清CTRP-3、MMP-9、TRAF6高水平患者溶栓后发生HT的危险度分别是低水平患者的0.113倍、12.487倍、8.172倍,差异有统计学意义（P<0.05）。结论 血清CTRP-3、MMP-9、TRAF6水平与急性脑梗死患者溶栓后HT的发生有关,三者联合检测可为急性脑梗死患者溶栓后HT的临床预测提供参考。

关键词: CTRP-3, MMP-9, TRAF6, 急性脑梗死, 出血转化