| ObjectivesThis study analyzed the relationship between plasma S1P and Sphk1 levels and ACI pathophysiology by detecting the dynamic changes of plasma S1P and Sphk1 levels in patients with acute cerebral infarction within 7 days to evaluate the predictive value of S1P and Sphk1 in prognosis and to find new clinical evidence for prognostic biomarkers.MethodsIn this study,60 patients with ACI who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Xi’an Medical College from June 2020 to December 2020 were selected as the case group.And 27 other patients who excluded ACI and other organic diseases of brain were treated in our hospital as the control group.All ACI patients were admitted to the hospital within 24 hours of onset,and received basic drug treatment after admission,but did not receive thrombolytic therapy.Plasma samples from ACI patients at admission(day 1 of onset),day 4,and day 7 were collected,as well as fasting plasma samples from the control group in the morning.The baseline data of all study subjects and the NIHSS score at the time of admission of ACI patients,the infarct volume on the third day of onset,and cervical vascular ultrasound were recorded.A double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to determine plasma S1P and Sphk1 levels.Patients with ACI were divided into two subgroups with a good prognosis(m RS≤2points)and a poor prognosis(m RS>2 points)according to the modified Rankin Scale(m RS)at 3 months of onset.Data statistical analysis adopts t test,chi-square test,Mann-Whitney U test,Spearman correlation analysis,ROC curve,and binary logistic regression analysis.Results1.Plasma S1P levels are dynamically evolving during the course of ACI.Plasma S1P levels in ACI patients are lowest on the first day(within 24 hours)after cerebral infarction,and gradually increase on the 4th and 7th days.The plasma S1P level on day 1 and day 4 was lower than the control group,the difference was statistically significant(P<0.05),and the plasma S1P level on day 7 compared with the control group,the difference was not statistically significant(P>0.05).There was no statistically significant difference in plasma Sphk1 level compared with the control group at each detection time point of ACI(P>0.05).2.The plasma S1P level of ACI patients at each test point in the good prognosis group(m RS≤2 points)was significantly higher than that in the poor prognosis group(m RS>2points),and the difference was statistically significant(P<0.05).Plasma at each test point S1P level was negatively correlated with m RS score at 3 months(P<0.05).3.In the poor prognosis group(m RS>2 points),the patients in the hypertension history,diabetes history,homocysteine level,admission NIHSS score,cerebral infarction volume and other indicators were significantly higher than those in the good prognosis group(m RS ≤ 2points).It is statistically significant(P<0.05).4.The results of binary logistic regression analysis showed that: S1P(day 1)is a protective factor for the prognosis of ACI patients,with an OR value of 0.987,95% CI(0.974-1.000)(P<0.05);admission NHISS score and diabetes history are ACI patients Independent risk factors for prognosis(P<0.05).5.The plasma S1P level of 274.56 nmol/L on the first day of the onset of ACI patients is the best predictive threshold for a good prognosis.The sensitivity corresponding to this threshold is 50.00%,and the specificity is 92.30%(P<0.05).6.The plasma S1P level of patients with ACI on the 4th and 7th days of onset was higher in the mild neurological deficit group(NIHSS≤4)than the moderate to severe neurological deficit group(NIHSS>4),and the difference was statistically significant(P<0.05);Plasma S1P levels were compared between the two groups on the first day,and the difference was not statistically significant(P>0.05).7.The plasma S1P level of ACI patients at each detection time point was higher in the small infarction group(≤5cm3)than the large infarction group(>5cm3),and there was no significant difference(P>0.05).8.The plasma S1P level of patients with ACI on the first and seventh days of onset was higher in the cervical vascular ultrasound without plaque group than in the plaque group,and the difference was statistically significant(P<0.05);on the fourth day,the plasma S1P level was compared between the two groups,The difference was not statistically significant(P>0.05).Conclusions1.Plasma S1P levels of ACI patients decreased within 24 hours of onset,increased after4 days,and returned to normal levels after a week.Plasma Sphk1 levels did not change significantly in the acute phase of the onset of ACI.2.Plasma S1P levels in ACI patients on day 1,4,and 7 after onset were negatively correlated with m RS scores after 3 months.The higher the plasma S1P level,the better the prognosis.The plasma S1P level has a certain predictive effect on the prognosis of ACI patients.3.S1P(day 1)may be a predictor of the prognosis of ACI patients. |
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