The predictive value of serum CXCL2 and CXCL8 levels for early neurological deterioration in patients with penetrating artery disease-type ischaemic stroke.

OBJECTIVE

To evaluate whether serum C-X-C motif chemokine ligand 2 (CXCL2) and C-X-C motif chemokine ligand 8 (CXCL8) predict early neurological deterioration (END) in penetrating artery disease (PAD)-type ischaemic stroke.

METHODS

This retrospective study included 146 PAD patients (June 2022-October 2024). Patients were stratified into END (n = 22) and non-END (n = 124) groups. Bioinformatics analysis using the GEO database and protein-protein interaction (PPI) analysis were performed. Serum CXCL2 and CXCL8 levels were measured by enzyme-linked immunosorbent assay (ELISA). Pearson correlation, receiver operating characteristic (ROC) curve, and logistic regression analyses were performed, followed by nomogram construction.

RESULTS

Bioinformatics analysis revealed CXCL2 and CXCL8 upregulation in cerebral infarction. END patients were older, had prolonged onset-to-admission times, higher admission National Institutes of Health Stroke Scale scores, and a higher branch atheromatous disease prevalence (all p < 0.05). END patients had elevated serum CXCL2 and CXCL8 levels (p < 0.05), which were positively correlated (r = 0.202, p = 0.015). ROC analysis indicated that the combination of CXCL2 and CXCL8 produced an area under the curve of 0.799 (95% CI: 0.720-0.878), outperforming individual markers. LASSO regression identified age, CXCL2, and CXCL8 as key variables. Multivariate analysis revealed age (OR = 1.140, 95% CI: 1.053-1.235, p = 0.001), CXCL2 (OR = 1.024, 95% CI: 1.006-1.043, p = 0.008), and CXCL8 (OR = 1.009, 95% CI: 1.003-1.016, p = 0.003) as independent END risk factors. The nomogram demonstrated excellent discrimination (training: 0.874; validation: 0.856) and good calibration (Hosmer-Lemeshow p > 0.05).

CONCLUSIONS

Serum CXCL2 and CXCL8 demonstrate potential as biomarkers for identifying END in acute PAD.