Serum KLF4 and OLFM-2 levels in acute cerebral watershed infarction and their relationship with in-stent restenosis after endovascular stent implantation

LI Kuo; WANG Li-xuan; ZHANG Chuan-suo; WANG Xiao-xuan; WANG Ru-yue

doi:10.11659/jjssx.02E025127

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Serum KLF4 and OLFM-2 levels in acute cerebral watershed infarction and their relationship with in-stent restenosis after endovascular stent implantation

Clinical Research | 更新时间：2025-12-22

- Serum KLF4 and OLFM-2 levels in acute cerebral watershed infarction and their relationship with in-stent restenosis after endovascular stent implantation
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 12, Pages: 1091-1095(2025)
- 作者机构：
  
  1.沧州市中心医院脑血管病二科，河北沧州061000
  2.沧州市中心医院放射介入科，河北沧州061000
  3.沧州市中心医院科研处，河北沧州061000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.02E025127
  CLC： R743
- Received：25 February 2025，
  
  Published：25 December 2025
- 稿件说明：
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李阔,王丽轩,张传锁等.急性分水岭脑梗死血清KLF4、OLFM-2水平及其与血管内支架植入术后再狭窄的关系[J].局解手术学杂志,2025,34(12):1091-1095.

.Serum KLF4 and OLFM-2 levels in acute cerebral watershed infarction and their relationship with in-stent restenosis after endovascular stent implantation[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1091-1095.
李阔,王丽轩,张传锁等.急性分水岭脑梗死血清KLF4、OLFM-2水平及其与血管内支架植入术后再狭窄的关系[J].局解手术学杂志,2025,34(12):1091-1095. DOI： 10.11659/jjssx.02E025127.

.Serum KLF4 and OLFM-2 levels in acute cerebral watershed infarction and their relationship with in-stent restenosis after endovascular stent implantation[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1091-1095. DOI： 10.11659/jjssx.02E025127.

摘要

目的

探讨急性分水岭脑梗死（ACWI）患者血清锌指样转录因子4（KLF4）、嗅素蛋白-2（OLFM-2）水平及其与血管内支架植入术后支架内再狭窄（ISR）的关系。

方法

选取2023年1月至2024年1月本院收治的187例ACWI患者作为研究对象（ACWI组），其中根据ISR发作情况将患者分为ISR组（75例）、非ISR组（112例）。另随机选取同期在本院体检中心检查的150例健康体检者作为对照组。比较ACWI组患者与对照组受试者、ISR组与非ISR组患者的临床资料及血清KLF4、OLFM-2水平。多因素

Logistic

回归分析影响ACWI患者血管内支架植入术后发生ISR的相关因素。受试者工作特征（

ROC

）曲线分析血清KLF4、OLFM-2对ACWI患者血管内支架植入术后发生ISR的预测价值。

结果

ACWI组患者血清KLF4水平低于对照组（

0.05），OLFM-2水平高于对照组（

0.05）。ISR组患者血清KLF4水平低于非ISR组，OLFM-2水平、术前NIHSS评分、LDL-C水平高

于非ISR组（

0.05）。多因素

Logistic

回归分析显示，校正术前NIHSS评分后，KLF4是ACWI患者血管内支架植入术后发生ISR的保护因素（

0.05），OLFM-2是ACWI患者血管内支架植入术后发生ISR的危险因素（

0.05）。血清KLF4、OLFM-2单独及联合预测ACWI患者血管内支架植入术后发生ISR的曲线下面积（

AUC

）分别为0.827、0.786、0.893，二者联合预测的

AUC

优于KLF4、OLFM-2单独预测（

KLF4

=3.236、

OLFM-2

=3.713，

0.05）。

结论

ACWI患者血管内支架植入术后血清KLF4水平降低，OLFM-2水平升高，与术后ISR发生相关。

Abstract

Objective

To investigate the serum levels of kruppel-like factor 4 （KLF4） and olfactomedin-like 2 （OLFM-2） in patients with acute cerebral watershed infarction （ACWI） and their relationship with in-stent restenosis （ISR） after endovascular stent implantation.

Methods

A total of 187 ACWI patients admitted to our hospital from January 2023 to January 2024 were selected as the study subjects （the ACWI group）. Among them， the patients were divided into the ISR group （75 cases） and the non-ISR group （112 cases） according to the occurrence of ISR. Another 150 healthy individuals who underwent physical examinations at the physical examination center of our hospital during the same period were randomly selected as the control group. The clinical data and serum KLF4 and OLFM-2 levels between the ACWI group and the control group， and between the ISR group and the non-ISR group. Multivariate

Logistic

regression was used to analyze the related factors affecting the occurrence of ISR after endovascular stent implantation in ACWI patients.

Receiver operating characteristic

（

ROC

） curve was used to analyze the predictive value of serum KLF4 and OLFM-2 for the occurrence of ISR after endovascular stent implantation in ACWI patients.

Results

The serum KLF4 level of patients in the ACWI group was lower

than that in the control group （

0.05）， and the OLFM-2 level was higher than that in the control group （

0.05）. The serum KLF4 level of patients in the ISR group was lower than that in the non-ISR group， while the OLFM-2 level， preoperative NIHSS score， and LDL-C level were higher than those in the non-ISR group （

0.05）. Multivariate

Logistic

regression analysis showed that after adjusting for preoperative NIHSS score，KLF4 was a protective factor for the occurrence of ISR after endovascular stent implantation in ACWI patients （

0.05）， while OLFM-2 was a risk factor for the occurrence of ISR after endovascular stent implantation in ACWI patients （

0.05）. The

areas under the curve

（

AUC

） of serum KLF4 and OLFM-2 alone and in combination for predicting ISR after endovascular stent implantation in ACWI patients were 0.827， 0.786， and 0.893， respectively. The

AUC

predicted by the combination of the two was better than that predicted by KLF4 and OLFM-2 alone （

KLF4

=3.236，

OLFM-2

=3.713，

0.05）.

Conclusion

The serum KLF4 levels decrease and OLFM-2 levels increase after endovascular stent implantation in ACWI patients， which is associated with the occurrence of postoperative ISR.

关键词

Keywords

references

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