Dynamic Changes And Significance Of Serum HMGB1 And TNF-? Levels In Early Progressive Cerebral Infarction Patients

ObjectiveThe aim of this study was to investigate the clinical risk factors of early progressive cerebral infarction and to explore the dynamic changes and clinica l significance of high mobility group protein box1 and tumor necrosis factor-a immunoinflammatory cytokines in sera of patients with acute ischemic stroke Methods75 patients with acute cerebral infarction were enrolled in the emergency hospital from Xiamen University First Affiliated Hospital from 2015-06-01 to2016-12-30,of which 30 were EPCI and 45 were NPCI.At the same time,50 p atients with atherosclerosis,hypertension,hyperlipidemia and other underlying d iseases were collected as matched control group with stroke risk factors.NIHS S scores were performed on the 1,3and 7day after admission.The serum level s of HMGB1 and TNF-? were measured at 1,3and 7 day after admission.Ou tpatient risk factors matched the control group to extract an early morning fasti ng serum to detect HMGB1,TNF-? concentrations.Results1?There was no significant difference in age,sex,history of hypertension,history of diabetes mellitus,history of coronary heart disease,smoking and al cohol consumption(0.2 ?P ?0.9)in the comparison of the basic characteri stics between the selected group of patients and the outpatient risk factors.2?There were no significant differences in age,sex,history of hypertension,history of coronary heart disease,family history of stroke,serum HDL-C conc entration,and smoking and drinking history in the comparison of the basic cha racteristics of EPCI and NPCI patients(P> 0.05).The incidence of carotid arte ry stenosis,serum TC,TG and LDL-C in EPCI group were significantly highe r than those in NPCI group(P <0.01 or P <0.05).3?The levels of HMGB1 and TNF-? in the fasting serum of the patients in the EPCI group were significantly higher than those in the control group(p<0.01)from day 1 to day 7(P <0.01)Compared with p <0.05).The levels o f HMGB1 and TNF-? in the fasting serum of patients in the NPCI group wer e significantly higher than those in the control group(p <0.01)from day 1 to day 7,and the serum HMGB1 concentration increased gradually(P> 0.05).T he serum TNF-? concentration peaked at the 3 day and decreased at the 7 day(p <0.05 in the group)compared with the previous time period(p <0.05)4?Comparison between the two groups: The levels of serum HMGB1 in t he EPCI group were significantly higher than those in the NPCI group on day1 day 3 and day 7(p <0.05).The levels of serum TNF-? in the EPCI group were higher than those in the NPCI group on the 3th and 7th day(P < 0.05),but there was no significant difference in the concentration of TNF-? in fastin g serum between the two groups5?The correlation analysis showed that there was a correlation between th e concentrations of HMGB1 and TNF-? in fasting serum between the two gro ups on day 1 and day 3(r = 0.26,0.30,p = 0.03,0.02).There was no signif icant correlation at day 7(r = 0.12,p = 0.25)6?The NIHSS score in the EPCI group gradually increased from day 1 t o day 7,and the NIHSS score in the NPCI group was stable and decreased.T here was no significant difference in NIHSS scores between the two groups on day 1 and significantly different from day 3 and day 7(p <0.001).7?The correlation analysis showed that HMGB1 concentration was positive ly correlated with NHISS(r = 0.6,0.5,0.5,p <0.001)on the 1,3 and 7 day.There was a positive correlation between TNF-? concentration and NHISS(r = 0.3,0.4,p <0.01)in the two groups of patients on day 1 and day 3,On d ay 7,there was no correlation between the concentration of TNF-? and NHISS in the fasting serum(r = 0.1,p = 0.25)Conclusion1,history of diabetes mellitus,carotid artery stenosis,dyslipidemia is the main risk factor for clinical progress of ACI.2,the dynamic changes of serum HMGB1 and TNF-? participate in the d ynamic pathophysiological process of ACI,and the higher the concentration is,the heavier the neurological deficit is.3,dynamic detection of serum HMGB1 concentration can be used to deter mine whether the early ACI has been a useful method of progress.