The Study On Genetic Factors Of Acute Middle-cerebral-artery Atherosclerotic Cerebral Infarction

Background Stroke is one of the major causes of disability and death in the worldwide,causing great pain to patients and families and is a heavy burden on society and economy.The ischemic stroke,which accounts for about 80% of stroke,is a disease with complex etiology and is affected by a variety of risk factors,such as high blood pressure,diabetes,smoking,diet,environmental and genetic factors.According to TOAST classification,stroke can be divided into large artery atherosclerosis type,cardiogenic embolism type,small artery occlusion type,other causes type and unknown causes type,among which large artery atherosclerosis type is the main subtype.More and more studies have confirmed that genetic factors play an important role in the incidence of ischemic stroke,and it is of great significance to explore the genetic related factors of acute large-artery atherosclerotic cerebral infarction for the prevention,diagnosis,treatment and prognosis of ischemic stroke.Objective To explore plasma markers and risk factors that may be genetically associated with acute middle-cerebral-artery atherosclerotic cerebral infarction.Methods A total of 176 patients were selected from the Neurology department of Dalian Municipal Hospital from January 2018 to October 2018 and diagnosed as acute middle-cerebral-artery atherosclerotic cerebral infarction by head DWI(diffusion weighted imaging)examination and clinical manifestations.The gender,age and other demographic information of the patients were collected.The illness history of hypertension and diabetes of the patients were collected.And the platelet count,eosinophil count,and c-reactive protein,homocysteine,serum thyroid three iodine glycine(T3),thyroxine(T4)and thyroid-stimulating hormone(TSH),antithyroglobulin antibody,anti-thyroid peroxidase antibody,fibrinogen and D dimer,blood type,three acyl glycerin,total cholesterol,high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A-Ⅰ(Apo A-Ⅰ),apolipoprotein B(Apo B),lipoprotein a and other blood test results of the patients were collected.Patients with acute anterior-circulation small-artery olocclusive cerebral infarction of the same period were used as the control group to analyze the differences of each index between the two groups,and to explore the genetic related blood markers and risk factors of acute middle-cerebral-artery atherosclerotic cerebral infarction.Results 1)Single factor analysis suggests that age,hypertension,the onset age of hypertension,HDL-C,apo A-Ⅰ,lipoprotein a and T3,TSH,fibrinogen are associated with acute middle-cerebral-artery atherosclerotic cerebral infarction,the differences between the two groups were statistically significant(p < 0.05).2)Multivariate Logstic regression analysis suggests that TSH(OR = 3.669,95% CI= 1.998 6.737),fibrinogen(OR = 2.778,95% CI= 1.418 5.441)are independent risk factors of acute middle-cerebral-artery atherosclerotic cerebral infarction,apo A-Ⅰ(OR = 0.003,95%CI=0.000-0.088)is an independent protective factor for acute middle-cerebral-artery atherosclerotic cerebral infarction.Conclusion 1)The risk factors of middle-cerebral-artery atherosclerotic cerebral infarction are different from those of small artery occlusion cerebral infarction.apo A-Ⅰ is an independent protective factor for acute middle-cerebral-artery atherosclerotic cerebral infarction,while TSH and fibrinogen are independent risk factors for acute middle-cerebral-artery atherosclerotic cerebral infarction.2)apo A-Ⅰ is affected by genetic factors,and apo A-Ⅰ may be a genetic factor associated with acute middle-cerebral-artery atherosclerotic cerebral infarction.