| BackgroundAcute ischemic stroke is the most common cerebrovascular disease.It has a high morbidity,disability,and lethality,which seriously threat human's health.Therefore,it is necessary to make early diagnosis and prognosis assessment of ischemic stroke.With the development of biological detection technology,more and more biomarkers have been applied to the diagnosis and treatment of diseases.ST2 is a hotspot biomarker in the study of cardiovascular disease in recent years,there exists a membrane bound(ST2 ligand)and soluble circulating form(sST2).ST2 mediates its Inflammation regulation effects through a heterodimer composed of IL-33..sST2 acts as a decoy receptor for interleukin-33,inhibiting IL-33/ST2 signaling and plays a role in heart failure,myocardial infarction,inflammation and diabetes.The purpose of this study is to explore the relationship between sST2 level with the severity and prognosis of acute ischemic stroke.MethodsA case-control study was conducted,in which,the patients with ischemic stroke were consecutively and prospectively enrolled from October 2015 to March 2017 into the department of Neurology of the First Affiliated Hospital of Zhengzhou University,for whom,the time of the onset of the first venous blood sample was no more than 72 hours.The subjects of control group were healthy people from medical center.All the subjects completed the collection and score of baseline data,medication and imaging assessment during hospitalization.The telephone interview or face-to-face follow-up were made in the third month,the sixth month and 1 year after acute ischemic stroke,ischemic stroke recurrence or death was taken as the end point,and the time of occurrence was recorded.EIASA was applied for the determination of Serum ST2 level.Statistical analyses were performed by using SPSS 16.0.The quantitative data were expressed with the mean ± standard deviation(x ± s),and the qualitative data were expressed with frequency(or percentage).Comparing the quantitative data of the case group and the control group,the Student t test was performed to compare the quantitative covariates conforming to normal distribution.The Mann-Whitney U test was performed to compare the quantitative covariates not conforming to normal distribution.When comparing the multiple groups of quantitative data,if they are consistent with independence,normality,homogeneity of variance,the quantitative data was analyzed with the method of variance,if not,the Kruskal-Wallis test was applied.Pearson ?2 test was used for the comparison between the qualitative data groups.Single factor Logistic regression was firstly used,and multiple factor Logistic regression analysis and correction of the influence of traditional risk factors were performed if there was statistical significance.The association was represented by the odds ratio(OR)and the 95% confidence interval(confidence interval).All statistical analyses were conducted with bilateral tests,if the value of P is less than 0.05,it is considered to be statistically significant.Results1.From October 2015 to March 2017,362 hospital admission patients who met the criteria for inclusion were included in the study.Among them,204 patients completed the second venous blood sampling in the hospital 7 days after admission,and the reexamination rate was 56.35%.A randomized number method was used to select 94 patients and 94 healthy people matched with the age and gender of the group to conduct a case-control study.The prevalence of diabetes and stroke in the case group(n=94)was higher than that in the control group,and the water leveal of the sST2 in the case group was significantly lower than that in the healthy control group(471.45±455.41 pg/mL vs 694.07±517.15 pg/mL).After the Logist multivariate regression model corrected the age,gender,hypertension,diabetes,coronary heart disease,and stroke history,there was still a difference in sST2 levels between the case group and the control group(OR=0.997,p=0.004).The area under the ROC curve of sST2 cases and control groups was 0.663(95% CI 0.585-0.741).2.Patients with minor stroke(NIHSS ?3)had higher sST2 levels than those with NIHSS >3(511.11±408.93 pg/mL vs.428.08±386.49 pg/mL,P=0.048).There was a negative correlation between sST2 level and NIHSS level in patients with acute ischemic stroke(r=0.118,p=0.024).Of the 362 patients,346 had acute infarct lesions,of which 246 were supratentorial infarction and 56 were infratentorial infarction,there was no significant correlation between infarct volume and sST2 level(r=-0.056,p=0.291).However,in the supratentorial infarct,the sST2 level of the infarct volume > 5 cm3 was lower than that of the infarct volume less than 5 cm3(516.99 + 426.35pg/mL VS 416.09 + 292.45 pg/mL,p=0.032),and sST2 concentration was negatively correlated with infarct volume(r=-0.15,p=0.018).3.Univariate logistic regression analysis showed that the level of sST2 at admission was not associated with recurrence or death at 6 months.4.The incidence of sST2 in patients with acute ischemic stroke decreased within 72 hours and then increased.Conclusions 1.The level of sST2 in patients with acute ischemic stroke at the time of admission(29.08±16.14 hours)is lower than that of the healthy control group.2.The level of sST2 in patients with acute ischemic stroke(29.08±16.14 hours)was negatively correlated with the NIHSS score and the infarct size of the supratentorial infarction at admission. |
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