| BackgroundAcute ischemic stroke（AIS）is a high-incidence vascular disease of the central nervous system.At present,the guiding ideology of clinical treatment of AIS is to restore blood flow and save the semi-dark belt of ischemia.But the blood flow supply is restored after a certain period of time,the function of Central Nervous System function not only failed to recover,but arise even more serious brain dysfunction,which is called ischemia reperfusion injury.It is generally believed that cerebral ischemia reperfusion injury（CIRI）is mainly related to inflammatory response,excitatory amino acid toxicity,apoptosis,oxidative stress and other mechanisms,of which the inflammatory response plays an important role in CIRI.There are relevant literature reports that macrophage migration inhibiting factor（MIF）as an inflammatory factor with a chemotactic effect,which is associated with the occurrence and development of ischemic stroke,but there is still controversy about the role of MIF in ischemic stroke disease.Objective1.To explore the correlation between MIF levels and cerebral infarction.2.By detecting the expression of MIF protein in ischemic reperfusion model rats brain tissue,to explore the correlation between MIF levels and reperfusion injury.Methods1.Clinical studies: 94 patients diagnosed with acute ischemic stroke in our hospital from November 2019 to June 2020 were collected as the experimental group,and 43 healthy subjects were collected as the control group during the same period.According to the volume and site of infarction shown by Magne Resonance imaging MRI,the experimental group was divided into infarct volume subgroup（51 cases in small volume infarction group,20 cases in medium volume infarction group,and 23 cases in large volume infarction group）and infarction site subgroup（23 cases in telencephalic infarction group,25 cases in diencephalic infarction group,17 cases in brainstem infarction group,and 16 cases in cerebellar infarction group）.The degree of neurological deficits in the experimental group was assessed according to the NIH Stroke Scale NIHSS,and the enzyme linked immunosorbent assay（ELISA）was used to detect the expression level of MIF in the serum of each group.The correlation between MIF levels and ischemic stroke,infarction volume,site of infarction,and degree of neurological deficit was analyzed by statistical methods.2.Basic studies: Fifty-six healthy SPF male SD rats were randomly divided into sham operation group,ischemia group（ischemia 2h group,ischemia 3h group,ischemia6 h group）,ischemia-reperfusion group（ischemia 2h reperfusion group,ischemia 3h ischemia-reperfusion group,ischemia 6h ischemia-reperfusion group）.Cerebral ischemia and reperfusion model was prepared by wire bolt method.TTC staining was used to measure the cerebral infarct volume ratio;Western blot was used to detect the expression levels of MIF.To investigate the expression of MIF in rat brain tissue and its relationship with reperfusion injury.3.Statistical analysis methods: SPSS 25.0 software was used for statistical analysis.Measurements that conform to the normal distribution are expressed in ±s。The t-test was used to compared between the two groups.One-way ANOVA was used for multi-group comparison,and LSD was used for two-to-two comparisons between groups.The adoption rate of the counting data is expressed,and the chi-square test is used for intergroup comparison.Logistic regression analysis was used to identify risk factors.The Speedman statistical method was used for correlation analysis.The above statistical methods are statistically significant in P<0.05.Results1.Clinical studies（1）There were no statistically significant differences in BMI,history of alcohol and tobacco,gender,age,history of hypertension,history of diabetes between the control group and the study group（P >0.05）;There were no statistically significant differences in general data between the infarct volume subgroup and the infarction site subgroup（P >0.05）.（2）There were differences of NIHSS scores between different subgroups of infarction volumes,that the larger the infarction volume,the higher the NIHSS score was,and the differences were statistically significant（F=267.717,P<0.05）.By using LSD method to compare two-by-two between groups,the results showed the differences between groups were significant（P<0.01）.There were differences in NIHSS scores between subgroups at different sites of infarction,but this difference was not significant（P>0.05）.（3）Compared with the control group,cholesterol（TC）and low-density lipoprotein（LDL）were significantly increased in the study group,and the difference was statistically significant（P<0.05）,while the differences in fasting blood glucose（Glu）,triglycerides（TG）,high-density lipoprotein（HDL）,creatinine（Cr）,and uric acid（UA）were not statistically significant between the two groups（P>0.05）.The differences of the above serological indices between the infarction volume subgroup and the infarction site subgroup were not statistically significant（P>0.05）.（4）The level of MIF in the study group was significantly higher than that in the control group,and the difference was statistically significant（t=-9.986,P<0.01）（5）There were statistically significant differences in the level of MIF between the infarct volume subgroups of the study group（F=124.325,P<0.05）.The larger the volume of infarction is,the higher the level of MIF level is.The results of the LSD statistical method showed the differences between the groups are significant（P<0.01）.（6）The level of MIF between the infarct site subgroups of the experimental group were different,but the differences were no significant（F=2.518,P>0.05）.（7）Spearman correlation analysis result showed that the level of MIF in the study group was positively correlated with the volume of infarction and the degree of neurological deficit（r=0.756,P<0.01;r=0.837,P<0.01）.（8）The results of multivariate logistic regression analysis showed that the level of MIF increased was independent risk factors for acute ischemic stroke（P<0.01）.The level of cholesterol（TC）and low-density lipoprotein（LDL）increased were risk factors for acute ischemic stroke,but they are not independent risk factors（P>0.05）.2.Basic studies（1）The expression of MIF protein in rat brain tissues in the ischemic 2h group,ischemic 3h group and ischemic 6h group was higher than that in the control group,and the difference was statistically significant（P<0.05）.By comparing different ischemic time points,it was found that MIF protein was most expressed in the ischemic 3h group,and the ischemic 6h group was lower than the ischemic 3h group and also lower than the ischemic 2h group.The difference in MIF expression at different ischemic time points was statistically significant（P<0.05）.（2）The volume of cerebral infarction in the ischemic reperfusion group was significantly higher than that in the control group（P<0.05）.The cerebral infarction volume in the ischemic 6h reperfusion group was significantly higher than that in the ischemic 2h reperfusion group and the ischemic 3h reperfusion group,and the difference between the groups was statistically significant（P<0.05）,indicating that the longer the ischemia time,the greater the volume of infarction after reperfusion.（3）The expression of MIF protein in rat brain tissues in the ischemic 2h reperfusion group,ischemic 3h reperfusion group and ischemic 6h reperfusion group was higher than that in the control group,and the difference was statistically significant（P<0.05）.By comparing different ischemic time points,it was found that MIF protein reached a peak in the ischemic 6h reperfusion group,and was significantly higher than that of the ischemic 2h reperfusion and ischemic 3h reperfusion groups,and the difference was statistically significant（P<0.05）,indicating that the longer the ischemia time,the more MIF expression was expressed after reperfusion.（4）The expression level of MIF after perfusion was significantly higher than before perfusion,and the t-test showed: the difference between MIF before and after perfusion at various time points were statistically significant（P<0.05）.That suggested MIF was involved in ischemic reperfusion injury.Conclusions1.The level of MIF correlates with acute ischemic stroke:the larger the volume of infarction and the more severe the neurological deficit,the higher the level of MIF is.2.MIF was involved in ischemic reperfusion injury. |
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