| BackgroundAcute cerebral infarction(ACI)is more and more popular.Atherosclerosis(AS)is the important reason for ACI.Inflammatory response is the pathomechanism in the process of AS forming.Nuclear factor of κappa B(NF-κB)and YKL-40 as the research focus,take part in the processes of plaques forming and acute complication when plaques repture.NF-κB and YKL-40 have been studied in coronary heart disease deeply,our society have found they have an important effect for the prevention and cure of myocardial infarction when we detect the levels of NF-κB and YKL-40 in serum.But the number of these researches in carotid plaques and ACI is small.So we undertake this research.ObjectivesTo investigate the relationnship between carotid plaque stability and the serum NF-κB,YKL-40 in patients with ACI,and the relationship among NF-κB,YKL-40 and ACI.At last,provide an evidence for early prevention and treatment for ACI patients.Methods(1)We selected 95 patients who first had ACI,all patients were diagnosed by CT or(and)MRI.All patients were accordance with the diagnosis standard which was formed in the fourth national cerebrovascular disease conference.(2)According to the examination results of carotid duplex ultrasound,the cerebral infarction group were divided into three subgroup: vulnerable plaques group(VP)29 cases,stable plaques group(SP)31 cases,no plaques group(NP)35 cases.Control group:50 cases(there were 8 cases who had stable plaques and 42 cases who had no plaques),all the healthy persons were conformed by CT or(and)MRI.(3)We collected their blood pressure(BP),body mass index(BMI),fasting blood glucose(FBG),triacylglycerol(TG),total cholesterol(TC),low density lipoprotein(LDL)and to calculate infarct size accordance with radiographic results.We assessed neurological severity scores through the US National Institutes of Health Stroke Scale(NIHSS)and cerebral infarction within 48 hours of onset.All patients had measured NF-κB and YKL-40 concentrations with enzyme-linked immune sorbent assay(ELISA)within 48 hours of onset and the 14 th day,and compared the differences with different plaques at different time.Then analyzed the relationship among the differences and carotid plaque,ACI.Results(1)The percentage of patients with carotid atherosclerotic plaques in ACI group is 63.2%,and the percentage of patients with unstable plaque is 30.1%.(2)When we compared ACI patients with the normal control group,the levels of systolic blood pressure,diastolic blood pressure,FBG,TC,TG and LDL in patients with ACI are higher than the health controls obviously(P<0.05).(3)Within 48 hours after the patients have been ill,the serum levels of NF-κB and YKL-40 are significantly higher than healthy controls(P<0.05).The serum levels of NF-κB and YKL-40 in VP group are significantly higher than the SP group and the NP group,the levels at the SP group are higher than the NP group.(4)At 14 th day,the serum levels of NF-κB and YKL-40 in ACI group are significantly lower than within 48 hours(P<0.05);and at 14 th day,the levels of NF-κB and YKL-40 of VP group are significantly higher than the SP group(P<0.05),the levels of the SP group are higher than the NP group(P<0.05).(5)The serum levels of NF-κB is related positively to the YKL-40(r=0.697,P=0.000);The serum levels of NF-κB is related positively to the infarct volume(r=0.734,P=0.000);The serum levels of NF-κB is related positively to the grade of NIHSS within 48 hours of onset(r=0.670,P=0.000);The serum levels of NF-κB is related positively to the levels of systolic blood pressure(r=0.385,P=0.000).The serum levels of YKL-40 is related positively to the infarct volume(r=0.315,P=0.002);The serum levels of YKL-40 is related positively to the grade of NIHSS within 48 hours of onset(r=0.367,P=0.000);The serum levels of YKL-40 is related positively to the levels of systolic blood pressure(r=0.573,P=0.000).(6)The serum levels of NF-κB and YKL-40 are significantly different among the patients with different infarcts volume(P<0.05).Conclusions(1)At different subgroup,NF-κB and YKL-40 are all higher obviously,but at different levels.The more worse of plaque stability,the more higher of the expression level.This suggests they are related to carotid atherosclerosis and plaque.(2)YKL-40 and NF-κB are abundantly expressed in the acute phase of ACI,more severe the disease,the higher the expression of both.This suggests YKL-40,NF-κB are positively correlated with ACI acute phase inflammatory activities,they can reflect the severity of patients with ACI. |
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