Periostin and TNF-α expression levels in peripheral blood of patients with acute cerebral infarction combined with obstructive sleep apnea syndrome and their predictive value for clinical prognosis

Objective: To detect the expression levels of periostin and tumour necrosis factor-alpha (TNF-alpha) in patients with acute cerebral infarction (ACI) combined with obstructive sleep apnea syndrome (OSAS) and to investigate their predictive value for clinical prognosis. Methods: In this case-control study, serum periostin and TNF-alpha levels were measured using ELISA, and patients were scored on the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Receiver operating characteristic curve(ROC) were generated to analyse the effect of peripheral blood periostin and TNF-alpha levels on poor prognosis. Results: NIHSS score, mRS score and peripheral blood periostin and TNF-alpha levels were higher in the observation group than in the control group (P < 0.001); serum periostin and TNF-alpha levels were positively correlated with the NIHSS score and mRS score (P < 0.001). Serum periostin and TNF-alpha levels were higher in patients with a poor prognosis than in those with a favourable prognosis (P < 0.001); the area under curve (AUC) values for the diagnosis of poor prognosis based on TNF-alpha, periostin or both factors were 0.868 (95% CI: 0.781-0.954), 0.834 (95% CI: 0.734-0.934), and 0.875 (95% CI: 0.792- 0.958), with sensitivities of 0.654, 0.846, and 0.654 and specificities of 0.944, 0.750, and 0.917, respectively. Conclusion: Patients with ACI combined with OSAS have elevated peripheral blood periostin and TNF-alpha levels, and the combination of these two factors has high predictive value for poor prognosis.