Cheng Zhang, Guohai Zhang, Zhehao Ye, Guojie Hu, Shengsheng Ge, Kai Luo, Zhao Li

Department of Neurosurgery, Shengzhou Hospital of Traditional Chinese Medicine, Shengzhou, Zhejiang Province, People’s Republic of China

Correspondence: Zhao Li, Email 13575538332@163.com

Background: Peroxiredoxin 2 (Prdx2) functions as an antioxidant and may be involved in acute brain injury. This study aimed to investigate whether Prdx2 can act as a serological marker for assessing the severity and forecasting stroke-associated pneumonia (SAP), early neurological deterioration (END), and neurological outcomes in acute intracerebral hemorrhage (ICH).
Methods: A collective of 167 patients with ICH and 61 controls underwent quantifications for serum Prdx2 levels. In addition, 61 of them allowed Prdx2 measurements on days 1, 3, 5, 7, 10, and 14 post-ICH. Admission National Institutes of Health Stroke Scale (NIHSS) score and hematoma size were documented, and the modified Rankin Scale (mRS) at six-month mark following ICH was registered. Correlations between serum Prdx2 and END, SAP, and poor prognosis (mRS scores of 3– 6) were determined using multivariate models.
Results: Serum Prdx2 levels of patients rapidly increased after stroke, with the highest levels on day 3, and were substantially higher during the initial 14 days than those of controls. Prdx2 levels were closely related to NIHSS scores, hematoma size, and mRS scores, were linearly relevant to likelihoods of SAP, END, and poor prognosis, and were independently predictive of SAP, END, and poor prognosis. These associations were not markedly affected by age, sex, hypertension, or other factors using subgroup analysis. Moreover, the possibilities of END, SAP, and poor prognosis were efficiently distinguished by Prdx2 levels. Its discrimination efficiency was similar to those of the NIHSS scores and hematoma size. The combination of the three variables displayed a higher predictive ability than the combination of NIHSS scores and hematoma volume for prognosis prediction.
Conclusion: A marked increase in serum Prdx2 levels after ICH may accurately mirror hemorrhagic severity and effectively predict END, SAP, and poor neurological outcomes, solidifying serum Prdx2 as a prognosticator of ICH.

Keywords: peroxiredoxin 2, intracerebral hemorrhage, outcome, severity, biomarkers