| Objective:The purpose of this study was to investigate the changes in serum Perilipin5 levels in patients with acute large atherosclerotic cerebral infarction,and to explore the effect of Perilipin5 levels on clinical symptoms and prognosis in patients with large atherosclerotic cerebral infarction.Methods:Continuous collection of 117 patients with acute cerebral infarction who attended Northern Jiangsu People’s Hospital from October 2018 to April 2019,and included 117 patients who were clearly diagnosed with large atherosclerotic cerebral infarction according to the TOAST classification criteria.National Institute of Health stroke scale(NIHSS)scores,collected baseline data of patients’ gender,age,past medical history,as well as laboratory indicators,and applied enzyme-linked immunosorbent assay to measure second-sky abdominal abdominal serum Perilipin5(Plin5)content.All patients were divided into progressive stroke and non-progressive stroke according to whether the NIHSS score increased by more than 1 point within 72 hours after admission.Single factor analysis compared the two factors.Baseline data,laboratory test results,and serum Perilipin5 levels of patients in this group.Multivariate regression analysis was used to identify independent risk factors for progressive stroke.Combining ROC curves to evaluate Perilipin5 levels in patients with aortic cerebral infarction.Predictive value of clinical symptoms progression in patients;3.Use of modified mRS(Rankin modified Rankin Scale,mRS)scores were used to evaluate the 90-day prognosis of patients.They were divided into good prognosis group(mRS≤2)and poor prognosis group(mRS>2).Univariate analysis was used to compare the baseline data,laboratory test results,and serum Perilipin5 levels of the two groups of patients.Perilipin5 levels,multivariate regression analysis was used to identify independent risk factors for progressive stroke,and the ROC curve was used to evaluate the predictive value of Perilipin5 levels in the prognosis of patients with large atherosclerotic cerebral infarction.Results:(1)A total of 117 patients with large atherosclerotic cerebral infarction were enrolled.According to whether the disease progressed after admission,the patients with major atherosclerotic infarction were divided into 29 strokes(24.8%)and nonprogressive stroke.88(75.2%)cases,In the two groups,gender composition,age,body mass index,smoking history,drinking history,systolic blood pressure,diastolic blood pressure,hypertension history,diabetes history,history of hyperlipidemia,low-density lipoprotein,blood glucose,total cholesterol,high-density lipid There was no significant difference between protein,triglyceride and creatinine(all P>0.05).The content of serum Perilipin5 in non-progressive stroke group was 3.24±0.62μg/L,and the content of serum Perilipin5 in progressive stroke group was 2.96±0.69μg/L;compared with nonprogressive stroke group,The content of Perilipin5 was significantly reduced,and the difference was statistically significant(P=0.032).Compared with the non-progressive stroke group,the NIHSS level,D-dimer content,and uric acid content in the progressive stroke group were significantly higher than those in the non-progressive stroke group(P = 0.000,P=0.027,P=0.02).The 90-day mRS score of the non-progressive stroke group was 1(2-4),and the 90-day mRS score of the progressive stroke group was 3(2-4).Compared with the non-progressive stroke group,the mRS score of the progressive stroke group was significant.Higher than non-progressive stroke group(P=0.000).Multivariate logistic regression analysis showed independent risk factors for the progression of clinical symptoms of non-atherosclerotic cerebral infarction with low serum Perilipin5 levels.The use of ROC curve to investigate the predictive value of Perilipin5 on the progression of large atherosclerotic cerebral infarction showed that there was no significant predictive value(AUC=0.674).(2)According to the 90-day mRS score,enrolled aortic atherosclerotic cerebral infarction was divided into 78 patients with good prognosis(66.67%)and 39 patients with poor prognosis(33.33%).In the two groups,gender composition,age,body mass index,smoking history,drinking history,systolic blood pressure,diastolic blood pressure,history of hypertension,history of diabetes,history of hyperlipidemia,low-density lipoprotein,blood glucose,high-density lipoprotein,glycerol There was no statistically significant difference between the three esters,uric acid,and creatinine(all P> 0.05).The content of Perilipin5 in the good prognosis group was significantly higher than that in the poor prognosis group(3.39±0.34μg/L VS 2.75±0.86μg/L)The difference was statistically significant(P=0.000);compared with the good prognosis group,the total cholesterol and D-dimer content in the poor prognosis group were significantly higher than those in the non-progressive stroke group(P=0.022,P=0.002).Multivariate logistic regression analysis showed that low serum Perilipin5 levels was an independent risk factor for the prognosis of atherosclerotic cerebral infarction(OR=0.299,95%CI: 0.081-0.647,P=0.005),NIHSS score,and total cholesterol content,Low-density lipoprotein content,and history of hyperlipidemia are suspicious influencing factors for the prognosis of large atherosclerotic cerebral infarction(all P <0.05),D-dimer,high-density lipoprotein,age,history of hypertension and aorta No significant correlation was found in atherosclerotic cerebral infarction(all P> 0.05).The ROC curve was used to analyze the serum Perilipin5 concentration level to distinguish the patients with good prognosis and those with poor prognosis in patients with aortic cerebral infarction.The area under the curve was 0.759.The Youden’s index was used to find that the optimal cutoff value for the good prognosis group and the poor prognosis group of aortic atherosclerotic cerebral infarction is 2.885μg/L(sensitivity 94.9%,specificity 53.8%).When the Perilipin5 concentration is greater than 2.885μg/L,it is more likely to detect a good prognosis of aortic atherosclerotic cerebral infarction.Conclusion: The serum perilipin5 level in patients with non-progressive stroke is elevated,and the patient’s prognosis is negatively correlated with the serum lipid droplet protein 5 level.serum PLin5 expression level has the potential to predict the clinical prognosis of patients with large atherosclerotic cerebral infarction. |
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