Study On The Level Of Expression Of Serum TRAIL In Patients With Cerebral Stroke

Background: Stroke and other cerebrovascular diseases are common diseases affecting the health of people, which has a highmorbidity rate andis an important factor causing death and disability. In recent years, with the development of medical technology, the mortality of cerebrovascular disease decreased and the survival rate is increasing, but the disability rate caused by it comes up.Therefore, how to prevent stroke and other cerebrovascular diseases, reduce the rate of disability of the disease,and improve people’s health levelbecomes an urgent problem to be solved.Stroke refers to the vascular obstruction or rupture caused by blood pressure and blood flow changes that are triggered by various inducing factors on the basis of cerebrovascular lesions, which in turn can cause brain function structural damage.This kind of diseasemainly manifest in two types: ischemic stroke and hemorrhagic stroke.Ischemic stroke is also called the cerebral infarction,and it is the most common type of stroke. Hemorrhagic stroke refers to the trauma caused by spontaneous cerebral hemorrhage within the brain parenchyma,and it is further divided into the simple cerebral hemorrhage(ICH) and cerebral hemorrhage broken into ventricles with subarachnoid hemorrhage(SAH).Apoptosis is the main form of delayed neuronal death which plays an important role in neuronal damage in cerebrovascular diseases. TRAIL is a new member of the tumor necrosis factor family.Because of its effect on tumor cell selective cytotoxicity, it attracts wide concern. However, subsequent studies showed that, TRAIL can also induce normal cells, such as neurons, oligodendrocyte to death. In 1999, Ana Martin-villalba confirmed by experiments that TRAIL exists in ischemic brain, and plays an important role in then neuronal apoptosis after cerebral infarction.Objective:Through the determination of serum TRAIL levels in patients with stroke, and it tries to investigate the relationshipbetween TRAIL and cerebral stroke.Methods: The infarction group consists the 96 cases of inpatients in Kaifeng Second People’s Hospital neural Department of internal medicine from January 2013 to December 2014. They are all patients with acute cerebral infarction onset, all within 48 hours(brainstem sites were excluded), clinical according with standard diagnosis of cerebrovascular disease(adopted at the Fourth National Conference on cerebrovascular diseases on), and confirmed by head CT. Cerebral hemorrhage group consists the 68 cases of hospitalized in Kaifeng Second People’s Hospital neural Department of internal medicine from January 2013 to December 2014, suffering from acute cerebral hemorrhage, all within 48 hours(excluding the onset of brainstem sites). Normal control group consists of 37 cases which are healthyelders in the Kaifeng Second People’s Hospital from January 2013 to December 2014. All of the objects are recorded by age and sex.Cerebral infarction group is scored by testing neural function defect, measuring the cerebral infarction area, and assessing stroke typesaccording to the clinical symptoms. Cerebral hemorrhage group, the neurological function was evaluated, volumetric measurement of cerebral hemorrhage, and according to the clinical symptoms assessed stroke types. The determination of TRAIL in serum is done respectively by enzyme-linked immunosorbent assay(ELISA) method. All data are expressed by differential mean ± standard, based on which the contrast analysis is conducted by using the statistical software.Results:1. Cerebral infarction serum TRAIL content is(73.18±33.18) pg/ml, cerebral hemorrhage group serum TRAIL content is(41.93±21.87) pg/ml, normal control group, the serum TRAIL content is(159.18±67.40) pg/ml. Normal control group was higher than that in cerebral infarction group(P < 0.05), cerebral infarction group was higher than that in cerebral hemorrhage group(P < 0.05).2. On the basis of clinical symptoms, according to China stroke scale, the serum levels of TRAIL is determined after typing the patients with cerebral infarction. The serum TRAIL content of light cerebral infarction patientsis(77.49±26.45) pg/ml, medium-sized cerebral infarction patients serum TRAIL content is(76.75±34.99) in serum of patients with cerebral infarction, severe TRAIL content is(64.25±38.57) pg/ml. There was no significant difference between the three groups(P > 0.05).3. Large area cerebral infarction patients’ serum TRAIL content is(40.53±25.44) pg/ml, the normal area of content is(71.90±27.19) pg/ml, lacunar content is(101.87±15.19) pg/ml, large area cerebral infarction is lower than the general area of cerebral infarction(P < 0.05), the normal area of cerebral infarction is lower than the cavity in lacunar cerebral infarction(P < 0.05).4. Simple cerebral hemorrhage patients’ serum TRAIL content is(52.68±16.65) pg/ml, cerebral hemorrhage broken into ventricles with subarachnoid hemorrhage patients’ serum TRAIL content is(20.44±13.58) pg/ml. Simple cerebral hemorrhage is higher than that of cerebral hemorrhage broken into ventricles of brain hemorrhage and subarachnoid hemorrhage(P < 0.05).5. On the basis of clinical symptoms, according to Chinese stroke scale, the different degree of cerebral hemorrhage patients after typing, determination of the serum levels of TRAIL, TRAIL content in serum of patients with mild brain hemorrhage is(47.28±26.50) pg/ml, the content of TRAIL in serum of patients with medium-sized cerebral hemorrhage is(34.61±22.05) pg/ml, TRAIL in the serum of severe cerebral hemorrhage content is(45.76±16.41) pg/ml, compared with no significant difference between three groups(P > 0.05).6. Large area cerebral hemorrhage patients’ serum TRAIL content is(16.48±14.46) pg/ml, the normal area of cerebral hemorrhage patients’ serum TRAIL content is(36.87±10.86) pg/ml, small area of cerebral hemorrhage patients’ serum TRAIL content is(65.56±11.41) pg/ml. Large area cerebral hemorrhage is lower than the general area of cerebral hemorrhage(P < 0.05); the general area of brain cerebral hemorrhage is lower than the small area of brain cerebral hemorrhage(P < 0.05).Conclusions: 1.Cerebral infarction and cerebral hemorrhage patients’ peripheral blood TRAIL were lower than those in normal control group and cerebral infarction group is lower than that of cerebral hemorrhage. Both the level of acute serum TRAIL in cerebral infarction and cerebral hemorrhage patients reduced.2.When intracerebral hemorrhage happens, the larger the hematoma volume is, the lower the serum TRAIL level is; the larger the infarction area is, the lower the serum TRAIL level is;the serum TRAIL level is not connected with the degree of nervous functional defect and the clinical symptoms of patients with Cerebral infarction and cerebral hemorrhage; the serum level of TRAIL of cerebral hemorrhage broken into ventricles of brain hemorrhage and subarachnoid hemorrhage patients is lower than that of patients with simple cerebral hemorrhage.3. TRAIL is involved in the whole process of cerebral infarction and cerebral hemorrhage, thus through the intervention of TRAIL’s pathway, it might improve the patients’ healing and provide new ideas for clinical treatment.