| Objective: Previous studies have shown that the Neuron Specific Enolase(NSE),S100 B protein(S100B)and Matrix Metalloproteinase-9(MMP9)are the specific biomarkers for studying cerebral injury,especially in ischemia injury.This study was to monitor these biomarkers for their expression in patents with carotid artery stenting(CAS)and demonstrate their functions in pre-operative evaluation and post-operative efficacy.Methods: Patients in Sichuan Province People’s hospital who were diagnosed unilateral carotid artery stenosis by Digital Subtraction Angiography(DSA)and underwent CAS,were selected as the operation group consecutively;the patients’ blood samples were collected at three time points,T1: prior to operation;T2: one day after operation(24 hours);T3: three days after operation(72 hours).The patients who were excluded for carotid artery stenosis by DSA,were assigned to the control group;Blood samples of these patients were collected before DSA(D1).The concentrations of NSE,S100 B and MMP9 in serum from patients of both groups were detected by ELISA.Results:(1)This study collected 40 patients in the operation group and 22 patients in the control group.Patients in the operation group implanted 48 carotid stents successfully,and the stents were well attached to the wall,no obvious residual stenosis was found,and the anterior blood flow was normal(TICI Level 3).All of the operation and control patients had no complications in the perioperative period.(2)The age(67.91±7.79,68.95±5.71),sex(59.09%,80.00%),smoker(36.36%,42.50%),atrial fibrillation(09.09%,15.00%),coronary heart disease(18.18%,22.50%),diabetes mellitus(18.18%,15.00%),high blood pressure(31.82%,55.00%),UA(408.4±56.2,401±72.5),HCY(12.33±6.2,13.01±4.97),Hb A1C(6.19±0.99,6.19±1.13),TG(1.77±0.62,2.47±1.21),TC(3.74±1.06,4.30±1.06)and LDL(2.23±0.66,1.69±0.74)in the control and operation patients had no statistical difference.(3)The serum concentrations of NSE(D1:293.52±105.54,T1:378.53±187.74,P>0.05),S100B(D1:2.74±1.16,T1:3.28±1.62,P>0.05)and MMP9(D1:18.11±8.89,T1:20.04±9.27,P>0.05)have no significant difference between the two groups at D1 and T1.(4)After CAS,the concentrations of NSE(T1: 378.53±187.74,T2: 302.65±160.46,T3: 280.60±159.22),S100B(T1:3.28±1.62,T2: 2.81±1.63,T3:2.59±1.55)and MMP9(T1:20.04±9.27,T2: 16.45±8.95,T3:12.62±8.32)in the operation patients’ serum decreased gradually,and had significant difference in pre-operation and post-operation.Conclusions: We conclude that the concentrations of NSE,S100 B and MMP9 in serum decreased with the improvement of cerebral reperfusion after CAS.NSE,S100 B and MMP9 can be used as laboratory biomarkers in the pre-operative evaluation and post-operative efficacy in monitoring of carotid stent implantation.In addition,the correct intervention of NSE,S100 B and MMP9 in the best time window after CAS may lead to the development of new methods for the treatment of ischemic reperfusion injury. |
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