Serum sCD40L and galectin-3 in the prognosis prediction of patients with acute ischemic stroke.

Background: To explore the value of serum soluble CD40ligand (sCD40L) and galectin-3 (galectin-3) for predictingthe therapeutic effect and prognosis of patients with acuteischemic stroke (AIS). Methods: 180 AIS patients admitted to the hospitalbetween March 2023 and March 2025 were selected asresearch participants. All patients received emergencytreatment with tenecteplase (TNK-tPA) combined withXuesaitong. Based on the therapeutic effect, patients weredivided into two groups: an effective group and an ineffective group. Serum sCD40L and galectin-3 levels weremeasured in both groups before treatment and 4 weeksafter, and the levels were compared. After discharge, allpatients were monitored for 3 months, and, based on theirmodified Rankin Scale (mRS) score, those with a goodprognosis and those with a poor prognosis were assignedto two groups. Using multivariate logistic regression, therisk factors associated with poor prognosis and inadequatetreatment in AIS patients were examined. Serum levels ofsCD40L and galectin-3 were analysed using a receiveroperating characteristic (ROC) curve to assess their prognostic value for poor prognosis and ineffective treatment inAIS patients. Results: Of the 180 research subjects, 146 were effectivelytreated (effective group), while 34 were ineffective (ineffective group). There were 142 patients with a good prognosisand 38 with a poor prognosis, representing an incidence of21.11%. After 4 weeks of treatment, serum levels ofsCD40L and galectin-3 were lower in the successful group than in the unsuccessful group (P< 0.05). Serum levels ofsCD40L and galectin-3 were higher in the poor-prognosisgroup than in the favourable-prognosis group (P< 0.05).Multivariate logistic regression analysis showed that AISpatients with elevated serum galectin-3 and sCD40L levelswere at increased risk of inadequate treatment and pooroutcomes (P< 0.05). The areas under the curve (AUCs) forserum galectin-3 and sCD40L in predicting treatment failure in AIS patients were 0.665 and 0.691, respectively,according to ROC analysis; the specificities were 70.08%and 77.51% , respectively, and the sensitivities were 62.53%and 62.58%, respectively. The combined prediction modelfor ineffective treatment using serum galectin-3 andsCD40L yielded an AUC of 0.784, with specificities andsensitivities of 65.18% and 81.25%, respectively. For predicting poor prognosis, serum galectin-3 and scd40ldemonstrated AUCs of 0.774 and 0.838, respectively; theirspecificities were 67.58% and 75.36% , respectively, whiletheir sensitivities were 75.06% and 80.04% , respectively.The combined prediction of serum galectin-3 and scd40lfor poor prognosis was less effective, with an AUC of 0.919,a specificity of 60.05%, and a sensitivity of 90.63%. Conclusions: Both sCD40L and serum galectin-3 levelshave some prognostic value for poor prognosis and ineffective treatment in AIS patients, and combining their detection can significantly improve predictive efficacy.