ABSTRACT
Objective To investigate the application values of S100-β protein,homocysteine (Hcy) and high-sensitive C-reactive protein (hs-CRP) in the diagnosis of acute ischemic stroke(AIS).Methods A total of 73 patients with AIS were enrolled in this study.The Non-stroke patients with similar symptoms were selected as control group (n =50).The relationship between levels of S100-β protein,Hcy and hs-CRP and infarct volume was evaluated.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic values of single and combined detection of these indicators in AIS.Results The levels of S100-β protein,Hcy and hs-CRP were higher in AIS patients than those in control group after adjusting the major vascular risk factors (P ＜ 0.05).There were significant differences in S100-β protein,Hcy and hs-CRP between different groups according to the infarct volume (P ＜ 0.05).S100-β protein,Hcy and hs-CRP positively were correlated with infarct volume (r =0.625,P =0.000;r =291,P =0.012;r =0.396,P =0.001 respectively).ROC curves showed that the diagnostic performances for AIS were as follows:S100-β protein (AUC =0.809,sensitivity:65.8％,specificity:82.0％),Hcy (AUC =0.775,sensitivity:54.8％,specificity:84.0％),hs-CRP (AUC =0.698,sensitivity:58.9％,specificity:78.0％) and Combined detection (AUC =0.878,the sensitivity:68.5 ％,specificity:94％).Conclusions S100-β protein,Hcy and hs-CRP protein can be used as biomarkers for AIS,which can help the diagnosis of AIS.S100-β protein can be used as a biomarker to evaluate the severity of AIS,Hcy and hs-CRP can also reflect the severity of AIS to some extent.Single detections of S100-β protein,Hcy and hs-CRP show limited value in the diagnosis of AIS.Combined detection gains a high specificity,but sensitivity is not very high.
ABSTRACT
Objective To investigate the change and possible role of bilirubin between with and without diabetes mellitus in the population of acute ischemic stroke. Methods ⑴A total of 610 hospitali-zation patients at the Department of Neurology in Affiliated Drum Tower Hospital of Nanjing University Medi-cal School from October 2008 to September 2012, who were diagnosed as acute ischemic stroke was divided into two groups based on diabetes mellitus or not, and 138 hospitalization patients with vertigo or dizzy diag-nosed as posterior ischemic while had no acute ischemic stroke were set as a control, divided into two groups based on the same standard too. Also, serum direct bilirubin and total bilirubin and new infarction or not were recorded. ⑵The levels of direct bilirubin and total bilirubin were compared between groups of diabetes and without diabetes, whatever in the population of acute ischemic stroke or not. Results ⑴The levels of serum total bilirubin and direct bilirubin were decreased obviously in the group of diabetes mellitus compared to the group of non-diabetes mellitus in the population of acute ischemic stroke [(17. 085 ± 0. 595)μmol/L vs (18. 920 ± 0. 487)μmol/L, P=0. 024;(4. 362 ± 0. 147)μmol/L vs (4. 876 ± 0. 135)μmol/L, P =0. 019 ] . ⑵There were no obvious difference of serum total bilirubin and direct bilirubin between the groups of diabetes mellitus and non-diabetes mellitus in the population of non-ischemic stroke ( P>0. 05 ) . Con-clusions Induction of bilirubin by acute ischemic stroke can be inhibited by diabetes mellitus, which may be one of the mechanisms of deteriorative brain damage by diabetes mellitus after acute ischemic stroke.
ABSTRACT
Objective To investigate the relationship between the matrix metalloproteinase-3(MMP-3)and the stability of carotid artery plaque,and explore MMP-3's prediction role on the attack and relapse of acute ischemic cerebrovascular events.Methods 100 patients with the first ever acute cerebral infarction,100 patients with chronic cerebral circulation insufficiency(CCCI)and 40 persons without cerebrovascular diseases were enrolled in this study.According to the carotid ultrasound examination,100 cerebral infarction patients were divided into three subgroup: unstable plaque group(45 patients,mixed plaque,soft plaque),stable plaque group(35 patients,plaque Group)and endometrial coarse group(25patients).Matrix metalloproteinase-3(MMP-3)levels of all the subjects were measured by enzyme-linked immunosorbent assay(as basal level).All the subjects were followed up for one year to observe cerebral infarction events.Serum MMP-3 levels of each group,and the basic serum MMP-3 levels were compared among patients who were attacked or relapsed cerebral ischemic with those who had not been attack cerebral ischemic during this period of time.Results 5 patients in the cerebral infarction group had relapse (5%),2 patients in the CCCI group were attacked by cerebral ischemic(2%),and no one in the normal control group was attacked by cerebral ischemic.Serum MMP-3 levels in the acute cerebral infarction group were significantly higher than CCCI group,and both groups were significantly higher than normal control group (P ＜0.05).The basic serum MMP-3 levels in all patients who were attacked by cerebral ischemic were significantly higher than those who had not been attack by cerebral ischemic during this period of time(P ＜0.05).The serum MMP-3 levels of the unstable plaque group were significantly higher than stable plaque group.And both groups were significantly higher than endometrial coarse group(P ＜0.05).Conclusions Elevated levels of matrix metalloproteinase-3(MMP-3)might have something with the stability of carotid atherosclerotic plaque,and participate the attack and the relapse of acute cerebral infarction.Determination of MMP-3 might be used to predict the attack and relapse of acute cerebral infarction.