The Role Of Serum Monosaccharide In The Diagnosis Of Cerebral Infarction

Objective:We observe and analyze the correlation between serum monosaccharide level and the severity of cerebral infarction,neurological deficit and TCM syndrome types by comparing eight kinds of monosaccharide in serum of normal persons and patients with cerebral infarction and cerebral hemorrhage.Methods: We collected serum samples of 73 cerebral infarction patients,44 healthy patients and 41 cerebral hemorrhage patients.We divided the 73 patients with cerebral infarction into three groups which are large volume group(19 cases);medium volume group(20 cases);small size group(34 cases)according to volume of cerebral infarction.According to the NIHSS score,we divided the 73 patients into three groups which are mild(29 cases),moderate(32 cases),and severe(12 cases).According to conscious disturbance divided into meridian syndrome group(62 cases)and organ syndrome group(11 cases).The standard curves of eight kinds of monosaccharides were drawn according to the results from HPLC analysis,and the regression equation was obtained.Serum samples were hydrolysed,derivatized and HPLC analyzed.We obtained each liquid chromatogram of serum samples,and calculated each monosaccharide concentration in the serum samples by the regression equation and the peak area of each monosaccharide.We analyzed and compared monosaccharides concentration in each group,and evaluated diagnosis value by drawing ROC curve.Results:(1)The levels of mannose,glucosamine,galactosamine,galactose,glucose,xylose and fucose in cerebral infarction group were higher than those in healthy control group;mannose,glucosamine,galactosamine,galactose concentrations in cerebral infarction group were lower than those in cerebral hemorrhage group;mannose,glucosamine and galactose amine,glucose,galactose,xylose and fucose concentration in cerebral hemorrhage group was higher than those in healthy group,the differences were statistically significant(P<0.0001).(2)there are seven kinds of monosaccharide levels in the diagnosis of cerebral infarction patients with higher value,the area under the ROC curve is greater than 0.7.The diagnosis of Man,Glc N,Gal N,Glc UA,Glc,Gal,Xyl,Fuc values were 1.5826mmol/L,3.9330 mmol/L,0.1965 mmol/L,0.0405 mmol/L,2.2860 mmol/L,1.9515mmol/L,0.0570mmol/L,0.1545 mmol/L,the area under the ROC curve were 0.887,0.873,0.810,0.579,0.797,0.870,0.859.0.787.(3)In patients with cerebral infarction,eight monosaccharide levels were increasing with the infarct volume,mannose(r=0.556,P=0.000),glucosamine(r=0.480,P=0.000),P=0.01(rs=0.3),galactose(r=0.466,P=0.000)levels correlated with infarct volume positively.In patients with cerebral infarction,eight monosaccharide levels were increasing with the NIHSS scores.Mannose(rs=0.710,P=0.000),glucosamine(rs=0.649,P=0.000),glucosamine(rs=0.480,P=0.000),glucose(rs=0.328,P=0.005);galactosamine(rs=0.676,P=0.000),fucose(rs=0.306,P=0.009)levels correlated with NIHSS scores positively.(4)The scores of NIHSS in the middle meridian group and the middle viscera group were different,and the difference was statistically significant(P=0.000).(5)The concentrations of five monosaccharides which are manzose,glucosamine,galactoamine,galactose and fucose in the viscera group were significantly higher than those in the middle meridians group(P<0.05).Conclusions:Monosaccharide levels in patients with cerebral infarction,normal controls and patients with cerebral hemorrhage were different.Seven kinds of monosaccharides have high diagnostic value.The levels of certain monosaccharides in patients with different infarct volume,different nerve function defects and different TCM syndrome types were also different.The detection of serum monosaccharides is helpful for the diagnosis and evaluation of the severity of the patients with ischemic cerebrovascular disease.