To investigate the diagonstic value of oxo-modified low-density lipoprotein (ox-LDL), caveolin-1, and serum axon growth inhibitory factor (Nogo-A) and postoperative cerebral edema in patients with acute cerebral hemorrhage before minimally invasive interventional hematoma removal.

A total of 105 patients with acute cerebral hemorrhage who received minimally invasive interventional hematoma removal at Suining Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and divided into cerebral edema group and non-cerebral edema group according to whether postoperative cerebral edema 48 h after the operation was complicated, and the general data, preoperative ox-LDL, caveolin-1 positive and Nogo-A levels of patients in the two groups were compared. Multivariate Logistic regression analysis was used to analyze the influencing factors of cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of preoperative ox-LDL, caveolin-1, and Nogo-A levels for cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage.

Among the 105 patients included in the study, 35 cases developed cerebral edema after surgery (cerebral edema group), with an incidence of 33.33%, the remaining 70 cases were in non-cerebral edema group. The levels of ox-LDL, Nogo-A and the positive rate of caveolin-1 in cerebral edema group were higher than those in non-cerebral edema group, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that preoperative ox-LDL, caveolin-1 positivity, and Nogo-A were independent influencing factors for cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage (P<0.05). ROC curve analysis showed that the cutoff values of ox-LDL and Nogo-A were 0.66 mg/L and 138.93 ng/mL, respectively. The AUC values for diagnosing cerebral edema after minimally invasive hematoma clearance in patients with acute cerebral hemorrhage were 0.893 (95%CI: 0.817-0.945) and 0.852 (95%CI: 0.770-0.914), respectively; the AUC of caveolin-1 positive diagnosis for cerebral edema after minimally invasive hematoma clearance in patients with acute cerebral hemorrhage was 0.657 (95%CI: 0.558-0.747); the AUC of the combined diagnosis of the three indicators was 0.950 (95%CI: 0.889-0.983), which was higher than the detection of each indicator separately, and the difference was statistically significant (P<0.05).

The levels of preoperative ox-LDL, caveolin-1 and Nogo-A are independent influencing factors for cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage. The combined detection of the three indicators has better predictive efficacy for postoperative cerebral edema than the individual application of each indicator.