Study On The Relationship Between G-CSF,GAL-3 And Risk Factors In Patients With Acute Anterior Circulation Ischemic Stroke At Middle And High Altitude

Objective: To determine the relationship between serum G-CSF,GAL-3 level and the degree of nerve injury in patients with acute anterior circulation ischemic stroke at medium and high altitude,and to analyze whether they are the influencing factors and predictive indicators of the disease,so as to provide a possible diagnosis and treatment basis for evaluating the acute phase condition and prognosis of patients.Methods: From July 2020 to July 2021,82 patients with acute anterior circulation ischemic stroke were selected from Qinghai Provincial People’s Hospital,and 36 healthy subjects were collected as the control group during the same period.Among them,69 patients(58.5%)were male and 49 patients(41.5%)were female,aged 45 – 80 years,with a mean age of 62.58 ± 11.26.The cases were divided into mild group according to NIHSS score on the day of admission,with score ≤ 3 and severe disabling stroke group with score > 3.General data,blood biochemical parameters,serum G-CSF,and GAL-3 parameters were collected from all study subjects to identify the influencing factors of acute anterior circulation ischemic stroke and evaluate the condition and prognosis of patients in the acute phase.Results: 1.The results of general data analysis showed that there were significant differences in age(F = 11.701,P < 0.001)and history of hypertension(χ2= 11.717,P = 0.003)among the three groups(P < 0.05);2.The results of blood biochemical index analysis showed that there were significant differences in G-CSF(F = 71.602,P < 0.001)and GAL-3(F = 75.313,P < 0.001)among the three groups;3.The results of binary logistic regression analysis showed that serum G-CSF(B =-0.012,P < 0.001)and GAL-3(B = 0.110,P = 0.001)were the influencing factors of the degree of nerve injury in acute ischemic anterior circulation stroke,of which G-CSF was a protective factor and GAL-3 was a risk factor;4.Pearson correlation analysis showed that NIHSS score was negatively correlated with serum G-CSF level(r =-0.431,P < 0.0001)There was a positive correlation between NIHSS score and serum GAL-3 level(r = 0.538,P < 0.0001);5.The results of ROC curve analysis showed that the area under the ROC curve was 0.928,sensitivity was 88.1%,and specificity was 80.2% for G-CSF,and 0.920,sensitivity was 95%,and specificity was74.5% for GAL-3.The area under the curve of both was > 0.5,the increased G-CSF had better predictive significance for mild epilepsy,and the increased GAL-3 had better predictive significance for severe disabling stroke.Conclusion: 1.The results of this study showed that the severity of acute symptoms of acute anterior circulation ischemic stroke at medium and high altitude was correlated with serum G-CSF and GAL-3 levels in the acute phase;2.The results of this study showed that serum G-CSF at medium and high altitude was an independent protective factor for acute ischemic anterior circulation stroke,while GAL-3 was an independent risk factor;3.The results of this study showed that elevated serum G-CSF at medium and high altitude had a better predictive value for mild acute anterior circulation ischemic stroke,and elevated GAL-3 had a better predictive value for severe disabling stroke.