Relationship Between Serum Resolvin E1 Level And Acute Cerebral Infarction

Background:Cerebral stroke is a disease withhigh incidence,death,disability.It has surpassed tumor diseases and has become the leading cause of death in China.Ischemic cerebrovascular disease is the vast majority type of stroke.Studies have shown that inflammation plays an indispensable role in the pathological process of ischemic stroke.As an important immune medium,inflammatory mediums participate in many types of inflammatory reactions,including cerebral ischemic injury after acute cerebral infarction.Induced inflammatory responses,and thus inflammatory mediums,may have important clinical predictive value for judging the severity and prognosis of cerebral infarction.Resolvin E1(RvE1)has recently been identified as a newly discovered anti-inflammatory lipid mediator and has been shown to have multiple inhibitory effects on inflammation and promotion of regression.As an important anti-inflammatory medium,its function has been confirmed in many inflammatory diseases.However,the biological function of RvE1 in the course of acute cerebral infarction has not been reported.By collecting relevant clinical data,this study analyzed the changes of endogenous RvE1 levels in patients with acute cerebral infarction and explored whether there is a correlation between RvE1 and acute cerebral infarction.Objectives:(1)To dynamically observe the changes of endogenous RvE1 expression in patients with acute cerebral infarction;(2)To analyze the relationship between endogenous RvEl levels and the severity of brain injury,and to evaluate the severity of acute cerebral infarction with RvE1 The early judgment of the degree and prognosis has important clinical significance.Methods:A total of 60 patients with acute cerebral infarction who were treated in the Department of Neurology of the First Affiliated Hospital of Xi'an Medical University from May 2017 to August 2017 were selected as the case group.The diagnosis was in accordance with the guidelines and confirmed by skull CT(Computed Tomography)or MRI(Magnetic resonance imaging).The onset time was less than 24 hours,both of which were the first onset.In addition,60 elderly persons with matched genders and ages were selected from the physical examination center.The elderly persons with no obvious abnormalities on the cranial CT/MRI served as the control group.Statistics of general clinical data and laboratory test results of 120 subjects in the case group and control group.We collected 3 ml of fasting blood on the first day,the third day,and the seventh day after the onset of illness in the case group,and 3 ml of fasting blood in the healthy control group.The levels of serum RvE1,Interlekin-6(IL-6),Interlekin-10(IL-10)at different time was measured by enzyme-linked immunosorbent assay(ELISA).According to the image data,the infarct area was divided into lacunar cerebral infarction(?1.5cm~2),small-area cerebral infarction(1.5-3cm~2),and large-area cerebral infarction(?3cm~2)representing different degrees of brain injury.National institute of health stroke scale(NIHSS)were used to assess the degree of neurological deficits in patients with cerebral infarction on the first day of admission,and were divided into mild(<4 points),moderate(4-15 points),and severe(>15 points).The patient's prognosis was assessed using mRS scores after onset in a mounth and was divided into a good prognosis(?2points)and a poor prognosis(>2 points).The data were statistically processed to analyze the changes in the expression level of RvE1 in patients with acute cerebral infarction,and the relationship between endogenous RvEl levels and the severity of brain injury and prognosis was analyzed.Results:1.Serum RvE1 levels in patients with cerebral infarction in the case group were significantly higher than those in controls(P<0.05),suggesting that RvE1 may be involved in the pathological process of inflammatory reaction after acute cerebral infarction;2.Cases of cerebral infarction in patients with different time onset of 1d,3d,7d The difference in the concentration of RvE1 was statistically significant(P<0.05).The concentration of RvE1 was significantly higher at 3 days than at 1 and 7 days,and RvE1 was significantly lower at 1 day than at 7 days(P<0.05);3.Serum RvE1 levels were negatively correlated with IL-6 levels in patients with infarction.Correlation(r=-0.495,P<0.05)was positively correlated with IL-10(r=0.364,P<0.05);4.Large-area infarction,small-area infarction,and lacunar infarct in the case group serum RvE1 expression levels were significantly different(F=22.989,P<0.05).The higher the RvE1 concentration was,the smaller the infarct size was.5.The serum RvE1 level in the mild neurological deficit group was significantly higher than that in the moderate and severity group(P<0.05);The level of serum RvE1 in moderate neurological deficit group was significantly higher than that in severe group(P<0.05);6.The serum RvE1 concentration in the good prognosis group was significantly higher than that in the poor prognosis group(P<0.05).Conclusions:1.The expression of serum RvE1 in patients with acute cerebral infarction showed dynamic changes,which was related to the development of the disease.The expression of RvE1 began to increase on the first day of disease,peaked on the third day,and then gradually decreased.The concentration of RvE1 on the seventh day was still higher than that on the first day.2.Serum RvE1 expression level is closely related to the severity and prognosis of patients with acute cerebral infarction.The higher the RvE1 concentration was,the milder the disease was,the better the prognosis was.Serum RvE1 concentration may become a biological indicator for assessing the severity and prognosis of patients with cerebral infarction.