Objective  To explore value of the serum high mobility group box 1 (HMGB1) combined with modified Edinburgh-Scandinavian Stroke Scale (MESSS) score in evaluating prognosis of acute ischemic stroke (AIS) patients with intravenous thrombolysis.

  Methods  A total of 150 patients with AIS were divided into mild group (n=85) and severe group (n=65) according to severity of the disease. Serum HMGB1, N-terminal pro-B-type natriuretic peptide (NT-proBNP), platelet (PLT), prothrombin time (PT), international normalized ratio (INR) and MESSS were compared between the two groups before and after treatment. Pearson linear analysis was used to evaluate the correlation between clinical indicators and score of National Institutes of Health Stroke Scale (NIHSS). The patients were followed up for 1 year. According to the score of modified Rankin Scale (mRS) score, AIS patients were divided into good prognosis group (n=108) and poor prognosis group (n=42), and clinical indicators were compared between two groups. Multivariate Logistic regression analysis was used to analyze the correlation between each index and prognosis. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of serum HMGB1 and MESSS for the prognosis of AIS patients.

  Results  The levels of HMGB1, NT-proBNP and MESSS in the severe group were significantly higher than those in the mild group before and after treatment (P < 0.05). Pearson correlation analysis showed that serum HMGB1, NT-proBNP and MESSS were positively correlated with NIHSS score (r=0.859, 0.702, 0.791, P=0.025, 0.047, 0.031). After one-year follow-up, the HMGB1 level and MESSS score in the poor prognosis group were significantly higher than those in the good prognosis group (P < 0.05). Multivariate Logistic regression analysis showed that serum HMGB1 and MESSS were risk factors for poor prognosis in AIS patients after one-year follow-up (OR=2.913, 2.887, P=0.029, 0.036). ROC curve analysis showed that the area under the curve (AUC) of HMGB1≤13.5 μg/L combined with MESSS≥25.5 in predicting poor prognosis of AIS patients was 0.819, P value was 0.028, the sensitivity was 82.6%, and the specificity was 88.4%.

  Conclusion  Combined detection of serum HMGB1 and MESSS can effectively evaluate the disease condition of AIS patients with intravenous thrombolysis, and has a high value in predicting short-term prognosis.