Clinical Analysis Of Cerebral Small Vascular Disease With Serum Inflammatory Cytokines And Endothelial Biomarkers

Objective:The purpose of this study was to prospectively analyze cerebral small vessel disease(CSVD)patients admitted to No.1 Hospital of Jilin University with clinical data,such as age,sex,hypertension,diabetes,stroke history,smoking history and other clinical data characteristics;to understand the characteristics of CSVD LDL and HDL,three glycerol ester,homocysteine,uric acid biochemical index;prospective analysis of relationship between activation factor between CSVD and Hy CRP,TNF-α,IL-6,v WF alpha and ICAM-1 serum markers of inflammation and endothelial cells;and to explore the relationship between the serological markers’ level of CSVD and cognitive function changes,and the relationship between the serological markers’ level of CSVD and the changes of imaging.In some of other researches,the plasma collected from patients with acute stroke,may simply reflected the effect of acute cerebral stroke,rather than real virulence factor activity,so that it is not good for fully understand the underlying trend of the disease.Therefore,in this research,serum markers of inflammation and endothelial activation factor were collected in non-acute stage(after at least 1 months),to understand the occurrence and development of CSVD more accurately,and tried to provide more ideas for the prevention and treatment of CSVD.Methods:From July 2017 to January 2018,collected 30 healthy people and 60 cases of cerebral small vessel disease patients(including 30 cases of acute lacunar infarction patients within 1 months and 30 cases with no acute lacunar infarction in the past 1 months)who were diagnosised according to the “STRIVE neuroimaging reporting guidelines 2003” in the neurology department of No.1 Hospital of Jilin University Department,and collected clinical data Including: gender,age,past history(hypertension,diabetes,ischemic heart disease,stroke,family history,smoking history),auxiliary examination(including low density lipoprotein cholesterol,high density lipoprotein cholesterol,triglyceride,homocysteine,uric acid,MRI,head and neck ultrasonography,Doppler ultrasound,etc.)and for all patients with MMSE,MES,MOCA,Hamilton depression scale,Hamilton anxiety scale,ADL,HIS,CDR and Tinetti gait scale.All the patients were fasting venous blood 5ml,the TDL-5-A 3000 r /min 10 min after centrifugal centrifuge stored at-23 deg.c inside the refrigerator;buy Shanghai Langton Biotechnology Co.,Hy CRP,IL-6,v WF,TNF-α,ICAM-1 ELISA(Enzyme linked,Immunosorbentassay,ELISA)kit,after all the ELISA test specimen collection after.All patients were measured by the above neuropsychological scale after admission.30 healthy patients as normal control group(A group);60 cases of cerebral small vessel disease patients as B group,then analysis the difference between these two groups of all clinical data and test results;the B group of 60 cases of cerebral small vessel disease patients were divided into two group depended on whether there are acute events,and then were compared between the two groups of Hy CRP,TNF-α,IL-6,v WF,ICAM-1 alpha;analysis of B group were Hy CRP,TNF-α,IL-6,v WF,alpha ICAM-1 serum concentration and the total score of each item,and correlation between radiographic severity(Imaging Group B mild change group,moderate change group B 2 imaging group,imaging change group B severe group)correlation;using SPSS19.0,R-project,Excel software for statistical analysis of all relevant data.Results:1 A/B two groups of hypertension,diabetes,ischemic heart disease,high density lipoprotein cholesterol,uric acid were statistically significant(P <0.05).2 The serum levels of Hy CRP,v WF,IL-6 and ICAM-1 between A and B were statistically significant(P <0.05).3 The serum levels of IL-6 and ICAM-1 between the two groups of B1/B2 were statistically significant(P<0.05).There was no statistically significant difference in serum levels of Hy CRP and v WF between the two groups(P>0.05).4 The serum level of IL-6 and MMSE scores and computing,language ability scores were negatively correlated with total score of MES;and its immediate memory,delayed recall,short,refers to the deduction of long delayed recall scores were negatively correlated with MOCA;the total score and visual space,attention,orientation scores related;scores were positively correlated with ADL scale.The level of serum ICAM-1 in group B was negatively correlated with the total score of MMSE scale and the scores of orientation and language ability,negatively correlated with the total score of MES scale and its short delayed recall and long delayed recall score,and negatively correlated with total score of MOCA.5 There was a global difference between IL-6 among B(1),B(2)and B(3)groups.There was a difference between IL-6 and B(1),B(2)group,B(1)and B(3)group.But there was no difference between B(2)group and B(3)group.ICAM-1 showed a holistic difference among B(1)group,B(2)group and B(3)group.There was a difference between B(1)and B(2)group,B(1)and B(3)group,but there was no difference between the group of B(2)and the group of B(3).Conclusion:1 Hypertension,diabetes,ischemic heart disease,high density lipoprotein cholesterol and uric acid are related to the occurrence of CSVD.2 The changes of serum levels of Hy CRP,v WF,IL-6 and ICAM-1 may be related to the pathogenesis of CSVD.3 IL-6 and ICAM-1 are significantly influenced by CSVD acute events.Hy CRP and v WF can separate disease trend from acute phase effect,and serve as a serological marker for CSVD.4 The levels of serum IL-6 and ICAM-1 may relate to the severity of cognitive impairment in CSVD patients.5 The level of serum IL-6 and ICAM-1 may relate to the severity of imaging changes in CSVD patients.