Analysis Of The Expression Of VWF And S-CD40L In The Blood Of Patients With Acute Cerebral Infarction Accompanied With Cerebral Microbleeds

Research background and purposeCerebral microbleeds(CMBs)is the leakage of blood cells to the surrounding tissues after severe microvascular injury,which leads to a subclinical manifestation of the deposition of the hemosiderin.The presence of CMBSs marks the occurrence of intracranial vascular damage in patients with bleeding tendency.As a sub clinical disease,CMBs lacks corresponding neurological dysfunction,at present,the diagnosis of CMBs depends on the magnetic susceptibility weighted imaging susceptibility weighted imaging(SWI)and T2 weighted imaging sequence(T2*).CMBs are specific manifestations of circular or oval,low signal lesions between the diameter of 2-5mm.The incidence of CMBs is different in different populations.The results showed that the incidence of CMBs in patients with acute cerebral infarction was about 40%.And acute cerebral infarction combined with CMBs has a certain correlation with the change of bleeding after infarction.However,up to now,the specific mechanism of cerebral hemorrhage is not clear.The results of the incidence to CMBs may be related to endothelial dysfunction and inflammatory response.Von Willebrand factor(vWF),as a protein polymer,is a kind of large molecular weight substance.It plays a very important role in the process of blood coagulation.At present,it has been shown that von Willebrand factor can well reflect the activity of endothelial cells.It is a reliable standard to predict the vascular endothelial function.Intravascular soluble CD40 ligand(s-CD40L)is a reliable indicator of vasculitis.In summary,this study chose to collect the results of vWF and s-CD40 L in the blood of patients with acute cerebral infarction,the detection results of the two factors in blood were analyzed,and the correlation between the two factors and CMBS was explored.The hope is helpful for clinical diagnosis and treatment of cerebral microbleeds.MethodsA total of 150 patients with acute cerebral infarction admitted to the Department of Neurology,Affiliated Hospital of Hebei University from February 2016 to October 2016 were collected,all patients were grouped by MRI sequence SWI.Among them,62 patients is acute cerebral infarction combined with microbleeds,and 88 cases of acute cerebral infarction is without cerebral microbleeds.The basic informations of 150 patients with acute cerebral infarction was collected and classified by OCSP.During the 2 weeks after the onset of the disease,the head CT was reviewed to determine whether there was a conversion of the infarct.30 healthy adults were selected as normal control group.Healthy adults' blood were collected on the day of physical examinations,and the blood of patients with acute cerebral infarction was collected on the day of admission.All blood samples were centrifuged,then,they were frozen at-70?.After the samples were collected,the content of vWF and s-CD40 L were determined by ELISA Kit in the same batch.According to the collected data using statistical methods,to find the relationship between the basic information?OCSP classification?the content of vWF ?the content of s-CD40 L and microbleeds,if P<0.05,the difference was considered statistically significant.Results1.The contents of vWF and s-CD40 L in venous blood of patients with acute cerebral infarction complicated with CMBs and acute cerebral infarction without CMBs were significantly higher than those in normal adults.And the contents of vWF and s-CD40 L in venous blood of patients with acute cerebral infarction complicated with CMBs were higher than those in patients with acute cerebral infarction without CMBs(P<0.001).2.The vWF and s-CD40 L contents of acute cerebral infarction in patients with different types of OCSP classification were different,and there were significant differences in the serum levels of the two kinds of factors between different types of patients(P<0.001).3.The contents of vWF and s-CD40 L in venous blood of patients with acute cerebral infarction complicated with CMBs were correlated with the number of CMBs.With the increase of CMBs,the contents of vWF and s-CD40 L also increased(R=0.873,P<0.001;R=0.762,P<0.001).4.Multivariate logistic regression analysis showed that age,hypertension,homocysteine and vWF were independent risk factors for acute cerebral infarction with CMBs.5.Acute cerebral infarction combined with CMBS was significantly higher than that of patients with acute cerebral infarction without CMBS,and there was a positive correlation between the number of CMBS(R=0.704,P<0.001).Conclusions1.The incidence of cerebral hemorrhage was closely related to age,hypertension,homocysteine,the contents of vWF and s-CD40 L.2.The contents of vWF and s-CD40 L in venous blood of patients with acute cerebral infarction complicated with cerebral microbleeds were higher than that in patients without cerebral microbleeds.3.VWFand s-CD40 L,especially vWF can be used as the detection index of patients with acute cerebral infarction were evaluated.4.There was a correlation between cerebral hemorrhage and CMBs in acute cerebral infarction.The incidence of hemorrhage was positively correlated with the number of CMBs.