Expression Level And Clinical Significance Of S100B And NSE In Patients With Acute Aortic Dissection Accompanied With Neurological Symptoms

Objective: aortic dissection is a very dangerous cardiovascular disease.It has high mortality and many complications.It seriously affects the prognosis and quality of life of patients.It has long been a difficult problem in medical field.Previous studies have confirmed that S100 B and NSE are specific markers for diagnosing central nervous system injury.However,the expression of S100 B and NSE in patients with acute aortic dissection and neurological symptoms is still not clear.This study was to investigate the expression level and clinical significance of S100 B and NSE in patients with acute aortic dissection with neurologic symptoms.Methods: a total of 90 patients with acute aortic dissection from the First Affiliated Hospital of Xinjiang Medical University from January2013 to January 2016 were enrolled in this study,and 30 healthy subjects were studied retrospectively.Among them,30 healthy people were selected as control group,30 patients with neurological symptoms(acute aortic dissection with neurological symptoms),and 60 patients without neurological symptoms(acute aortic dissection with neurological symptoms).The pathological data of autopsy of 15 cases of sudden death of aortic dissection and 6 cases of sudden death of non aortic dissection were analyzed retrospectively in our hospital autopsy.The non sudden death in patients with aortic dissection in 6 cases as control group,the neurological symptoms associated with group(autopsy confirmed acute aortic dissection in 5 cases of neurological symptoms associated with sudden death),without neurological symptoms group(autopsy confirmed10 cases of acute aortic dissection without neurological symptoms associated with sudden death)as the experimental group.The concentration of serum S100 B and NSE was detected by chemiluminescence.The expression of S100 B and NSE in brain tissuewas detected by immunohistochemical staining and immunofluorescence staining.Results: among 30 cases of acute aortic dissection with neurological symptoms,8 cases had hypoxic ischemic encephalopathy,5 cases had ischemic stroke,16 cases had ischemic neuropathy,and 1 cases had spinal cord ischemia.There were 14 cases of A type aortic dissection,about 46.7%(P=0.000).Compared with the control group,the serum NSE concentration in the patients with neurologic symptoms was significantly lower than that of [994.03(728.19,1921.14)pg/L ratio 4389.94(718.42,7228.84)pg/L](P=0.0019).The systolic pressure in the group with neurologic symptoms was significantly lower than that of the non neurologic symptom group(P=0.015).Compared with the non neurologic symptom group,the serum NSE concentration in the group with neurologic symptoms was significantly lower than that of [1402.09(836.46,6064.59)ng/L](P=0.041).There was no significant change in serum S100 B concentration [32.31(23.09,46.75)pg/L ratio 36.98(26.88,62.65)pg/L](P=0.217).5 cases of AAD with sudden neurologic symptoms were confirmed by autopsy,all of which were ischemic stroke.Compared with the control group,the positive expression rate of S100 Bastrocytes in the patients with neurologic symptoms increased significantly(P=0.018).HE staining showed that astrocytes were proliferated with sudden neurotic death.The number of positive expression of immunofluorescent S100B-astrocytes in patients with neurologic symptoms increased.Compared with the control group,there was no significant difference in the positive expression rate of NSE-neurons in patients with sudden death of aortic dissection(P=1.000).Conclusions: Serum NSE level decreased and the positive expression of S100B-astrocytes significantly increased in AAD patients with NS.Hence,S100 B and NSE might be potential markers for the diagnosis of AAD with NS.