The Correlation Between the Level of Macrophages and Inflammatory Factors and the Clinical Prognosis of Acute Stroke

Abstract

Atherosclerosis is the primary mechanism of acute ischemic stroke (AIS) due to its association with inflammation and its impact on the formation, development, and stability of arterial plaques. In addition, AIS is characterized by a higher risk of poor prognosis, although the exact mechanisms responsible for this remain unclear. Currently, there is a lack of laboratory indicators for early assessment of disease progression and prognosis in AIS. It is hypothesized that macrophages and inflammatory factors play a role in the subsequent deterioration of AIS, possibly through their impact on cellular processes. The purpose of this study was to investigate the correlation between macrophages and inflammatory cytokines levels and clinical outcomes in individuals with acute stroke. A retrospective analysis was conducted of clinical data obtained from 252 AIS patients who received treatment at our hospital. After a period of 6 months of treatment, the patients were categorized into groups with either a favorable or unfavorable prognosis, based on their scores on the modified Rankin scale (mRS). Subsequently, a comparative analysis was conducted on the clinical data, macrophage migration inhibitory factor (MIF), and inflammatory cytokines (hs-CRP, IL-6) between the two groups, followed by an assessment of the factors that significantly influenced poor prognosis in AIS using a logistic regression model. Finally, Spearman correlation analysis was employed to excavate the relationship between MIF, hs-CRP, IL-6, and mRS. Analysis revealed that among the 252 patients with AIS, 75 individuals exhibited a poor prognosis, resulting in an incidence rate of 29.76%. The analysis using a logistic regression model demonstrated that MIF, hs-CRP, and IL-6 independently contributed to an increased risk of poor prognosis in AIS (P < 0.05). When assessing the ability to predict poor prognosis in AIS, the AUC for MIF, hs-CRP, and IL-6 were found to be 0.964, 0.723, and 0.774, respectively. Moreover, the sensitivity and specificity values were obtained, with MIF exhibiting higher values of 0.867 and 0.944, respectively. hs-CRP had a sensitivity of 0.680 and a specificity of 0.701, while IL-6 demonstrated a specificity of 0.927 and a sensitivity of 0.413. The Spearman correlation analysis showed a positive correlation between MIF, hs-CRP, and IL-6 and mRS (r = 0.634, 0.546, 0.530, all P < 0.001). In conclusion, the findings suggest that MIF, hs-CRP, and IL-6 are associated with poor prognosis in AIS and have the potential to serve as biomarkers for early prediction of AIS prognosis.