The Impact Of Hypoxia Inducible Factor-1α、neuroglobin On The Severity And Prognosis Of Ischemic Stroke

Objective:Ischemic stroke is one of the major nervous system diseases which can make patients disability and death. However, in most countries, only thrombolysis has been considered as an effective treatment for acute Ischemic Cerebrovascular Disease, but because of its clinical applications need to follow strict time windows and after application may appear a lot of complications, currently about only 5% of Ischemic Cerebrovascular Disease patients receiving thrombolytic therapy. therefore developing a new effective treatment is all of the researchers’ common goal. In this study,By observing the concentrations of hypoxia inducible factor-1a(Hypoxia inducible factor-1α, HIF-1α) and neuroglobin(Neuroglobin, NGB) which in the Ischemic Cerebrovascular Disease patients plasma. revealing the impact of HIF-1α and neuroglobin on the severity and prognosis of cerebral infarct patients and exploring the relationship between the two indexes. We hope through this research we can provide new ideas and methods for the clinical treatment of cerebral infarct.Method:1 Sample:Select 80 patients which stay in the Chengde Medical College Hospital Department of Neurology with ischemic stroke from January to March 2014 as the object of study. 48 male and 32 female, average(60.31 ± 13.37) years old. Diagnosis were comply with the 4th National cerebrovascular disease Conference revised cerebral infarct diagnostic criteria. Exclude coronary heart disease, pancreatic disease, blood disease, severe kidney disease, autoimmune diseases, cancer and trauma caused cerebral infarct, chronic hypoxia diseases and pregnant patients. After Check-in the hospital, all patients were given improve blood circulation, Anti-platelet aggregation, brain protection etc treatment programs.2 Sample collection and measurement: All patients fasted for 12 to 14 hours overnight, and then select elbow venous blood next morning. Separated plasma samples and storage them in the —80 ℃ refrigerator. Using ELISA to measured the concentration of HIF-1α and NGB which in the patients’ plasma. Other conventional indicators, for example blood glucose, blood lipids, clotting.which may had an impact on ischemic stroke’s advance were measured by laboratory.3 Grouping and observe indicator: according to the average concentration of HIF-1α and NGB in plasma, put all of the cerebral infarct patients into four groups. The plasma concentrations of HIF-1α> 645.73 pg / ml patients divided into high HIF-1α group, the others divided into low HIF-1α group. The plasma concentrations of NGB> 108.47 ng / ml patients divided into high NGB group, the others divided into low NGB group. According to NIHSS, make neurologic impairment score after cerebral infarct patients were received treatment the first day and the fourteenth day. According to the results of the first day NIHSS score divided the patients into mild middle and severe cerebral infarct, according to the change of the twice NIHSS score divided the prognosis of cerebral infarct patients into good prognosis(basic recovery, significant progress, progress) and poor prognosis(no change, worse, death) for research.4 Statistical analysis: Compare the high HIF-1α group patients with the low HIF-1α group patients using Wilcoxon rank sum test to see if the severity of ischemic stroke have differences among the two groups.as seem as the two groups of NGB. Using chi-square test analyze the differences in the prognosis of ischemic stroke between high and low HIF-1α group patients. The seem as the two groups of NGB. Logistic analysis to determine whether the concent of hypoxia inducible factor-1α and neuroglobin in plasma influence the effect of cerebral infarct,s prognosis independent of age, gender, blood pressure, glucose, BMI, LDL-C, HDL-C, Lp(a), TC, TG, FIB and other relevant factors may influence the prognosis of cerebral infarct. Using rank correlation analysis revealed the relationship between HIF-1α and NGB.Result:1 Compared the severity of ischemic stroke of low HIF-1α group patients with high HIF-1α group patients: The severity of ischemic stroke had differences among the two groups of patients,which had statistically significant(Z = 2.131, P = 0.033), the severity of ischemic stroke on low HIF-1α group patients were lighter than high HIF-1α group patients.2 Compared the prognosis of low HIF-1α group patients with the high HIF-1α group patients : by conventional therapy low HIF-1α patients had good prognosis accounted for 70%, high HIF-1α patients had good prognosis accounted for 40%, so the prognosis of low plasma HIF- 1α group patients were better than high HIF-1α group patients(χ2 = 6.963, P = 0.008).3 Analysis the factors which influence the prognosis of ischemic stroke by logistic regression analysis: Plasma concentrations of HIF-1α in patients influence the effect of cerebral infarct’s prognosis is a risk factor independent of age, blood pressure,sex, blood lipids, blood glucose clotting and the like(P <0.05).4 Low NGB group patients compared with high NGB group patients for the severity of ischemic stroke : the difference between the two groups of patients were statistically significant(Z = 2.437, P = 0.015), the severity of ischemic stroke on low NGB group patients were lighter than high NGB group patients.5 Compared the prognosis of low NGB group patients with the high NGB group patients: by conventional therapy low NGB patients had good prognosis accounted for 65%, high NGB patients had good prognosis accounted for 40%. Therefore, the prognosis of low plasma NGB group patients were better than high NGB group patients(χ2 = 3.868, P = 0.049).6 Analysis the factors which influence the prognosis of ischemic stroke by logistic regression analysis: Plasma concentrations of NGB in patients influence the effect of cerebral infarct’s prognosis is a risk factor independent of age, blood pressure,sex, blood lipids, blood glucose clotting and the like(P <0.05).7 Analysis the relationship between plasma concentrations of HIF-1α and NGB: Using Spearman rank correlation analysis the relationship between plasma concentrations of HIF-1α and NGB in 80 ischemic stroke patients. The results showed that HIF-1α and NGB had positive correlation( r = 0.675, P <0.0001).Conclusion:1 HIF-1α and Ngb can reduce the severity of cerebral infarct and improve the patients’ prognosis by neuroprotection function.2 Monitoring the concentrations of plasma HIF-1α and Ngb in patients with ischemic stroke can be seen as a new reference index which can determine the severity of cerebral infarct, evaluation the recovery of neural function, and assess disease prognosis.3 Plasma concentrations of HIF-1α and NGB in patients influence the effect of cerebral infarct’s prognosis is a risk factor independent of age, blood pressure,sex, blood lipids, blood glucose clotting and the like.4 HIF-1α expression is correlated with NGB.