| Objective:To observe the dynamic changes of IL-17 and MMP-9 in the progression of cerebral infarction,to explore possible immune mechanisms,and to analyze the risk factors that may lead to the development of cerebral infarction.Methods:Patients with neurological cerebral infarction at the First Affiliated Hospital of Xiamen University were divided into progressive cerebral infarction group(PCI)and non-progressive cerebral infarction group(NPCI)from 2016-01-01 to 2017-12-31.Divided into non-cerebral infarction control group(NCI).There were 30 cases of progressive cerebral infarction(PCI),50 cases of non-progressive cerebral infarction(NPCI),and 40 cases of non-cerebral infarction control(NCI)outpatient physical examination.The incidence of acute cerebral infarction in two cerebral infarction groups was no more than 24 hours,without thrombolysis and endovascular treatment.Blood samples were collected from patients with progressive group cerebral infarction(PCI)and non-progressive cerebral infarction(NPCI)on the 1st,3rd,7th,and 14 th day after admission.Non-cerebral infarction control group(NCI)That is,outpatient physical examination to the day of physical examination blood,serum IL-17,MMP-9 levels.At each of these four time points,the progression of cerebral infarction group(PCI),non-progressive cerebral infarction group(NPCI)and non-cerebral infarction control group(NCI)were compared.NIHSS scores were performed on days 1,3,7,and 14 for all patients with cerebral infarction.The serum levels of IL-17,MMP-9,and NIHSS scores in all patients with cerebral infarction were analyzed at four time points,and the risk factors that may cause the progression of cerebral infarction were analyzed.Result:1.Serum IL-17 levels in progressive cerebral infarction group were higher than those in non-progressive cerebral infarction group at four time points(P<0.01);serum IL-17 levels in progressive group were higher than those in control group at four time points(P<0.01);non-progressive cerebral infarction group was higher than the control group(P<0.01).2.Serum MMP-9 levels: progression group was higher than non-progression group and control group at four time points(P<0.05);non-progression group was higher than control group at 1st,3rd and 7th day.(P<0.05),non-progression group and control group were basically the same on the 14 th day(P>0.05).3.There was a correlation between serum IL17 level and NIHSS score on the 1st,3rd and 7th day(r=0.395,r=0.7482,r=0.640,P<0.01);there was no correlation on the 14 th day(r = 0.147,P = 0.195).4.There was no correlation between MMP-9 level and NIHSS score on the first day(r=0.161,P=0.153);there was correlation at the other three time points(r=0.578,r=0.518,r=0.371,P<0.01).5.Analysis of risk factors: There was no significant difference in smoking,alcohol consumption,hypertension,family history of stroke,coronary heart disease,hyperlipidemia,age,and NIHSS scores in the progression group compared with the NPCI group(P>0.05);Non-progressive cerebral infarction group had significant differences in the history of diabetes,carotid artery stenosis,fever,fibrinogen,homocysteine,blood glucose,TC and TG(P<0.05).Logistic regression analysis showed that risk factors for progression of cerebral infarction were fibrinogen,homocysteine,blood glucose,TC,and TG(P<0.05).The degree of risk is ranked in descending order: fibrinogen,TG,homocysteine,TC,and blood glucose.The history of hypertension,diabetes,carotid artery stenosis,and the risk of fever were relatively small(P>0.05).Conclusion: 1.Serum levels of IL-17 and MMP-9 play a role in the progression of cerebral infarction.Increased levels of serum IL-17 and MMP-9 indicate that cerebral infarction may progress.2.Serum levels of IL-17 and MMP-9 were associated with neurological deficits.3.The risk factors for progression of cerebral infarction from the largest to the smallest ranked: fibrinogen,triglycerides,high homocysteine,cholesterol,blood sugar. |
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