Study On The Correlation Of Osteopontin And Fibrinogen Level With The Degree Of Nervous Functional Defects And Prognosis In Patients With Acute Cerebral Infarction

Objective:To explore the correlation of osteopontin and fibrinogen level with the degree of nervous functional defects and prognosis in patients with acute cerebral infarction,provide theoretical basis for the disease progress and outcome.Method:The case group consists of 148 patients with acute infarction who were admitted into the neurology department of the affiliated hospital of chengde medical college during September 2017 to March 2018 and 102 volunteers in the same period were selected as the control group.Record the information of of each subject,including Age,gender,previous medical history(including diabetes history,hypertension history)and personal history(including smoking history,drinking history),and some blood biochemical test indicators,such as,triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),highdensity lipoprotein cholesterol(HDL-C),uric acid(UA),homocysteine(Hcy)and white blood cell count(WBC)were taken and the OPN and FIB levels of all subjects were detected respectively on admission.According to the National Institutes of Health Stroke Scale(NIHSS)score,the case group was divided into mild cerebral infarction group(NIHSS score<5)and severe cerebral infarction group(NIHSS score>5).According to the modified Rankin Scale(mRS)after 90days'treatment,patients were divided into good prognosis group(mRS score?2)and poor prognosis group(mRS score>2).The differences of each index between the case group and the control group and between the group with good prognosis and the group with poor prognosis were compared respectively.Use the Spearman correlation analysis to investigate the correlation of OPN and FIB level with the degree of NIHSS score and mRS score,for patients with acute cerebral infarction,draw the receiver operating characteristic(ROC)curve to evaluate OPN and FIB level predictive value on admission for the prognosis of patients with acute cerebral infarction,Logistic regression was used to analyze whether OPN and FIB levels on admission were independent risk factors affecting the severity and poor prognosis of acute cerebral infarction.Result:1.The levels of OPN,Hcy,FIB,TC,LDL-C and UA in the control group were significantly lower than those in the case group(Z=-3.395,-3.811;t=3.295,3.574,3.231,2.685;P<0.05).2.Logistic regression results showed that OPN(OR=1.187,95%CI1.067~1.320,P<0.05),FIB(OR=3.153,95%CI 1.688~5.888,P<0.05)and LDL-C(OR=3.235,95%CI 1.708~6.126,P<0.05)were independent risk factors affecting the severity of acute cerebral infarction.3.OPN and FIB levels were positively correlated with NIHSS score on admission(r_s=0.387,0.465;P<0.05);OPN and FIB levels were positively correlated with mRS score on admission(r_s=0.364,0.399;P<0.05).4.OPN,Hcy,FIB,TC,LDL-C and age in the group with good prognosis were significantly lower than those in the group with poor prognosis(Z=-4.171,-1.990;t=3.909,2.240,3.392,4.980;P<0.05).5.The ROC curve suggested a moderate sensitivity(77.8%)and specificity(58.3%)of OPN for predicting prognosis with an optimal cut-off point at 4.698(area under the curve:0.716,95%CI 0.623~0.809,P<0.05);the ROC curve suggested a moderate sensitivity(71.1%)and specificity(73.8%)of FIB for predicting prognosis with an optimal cut-off point at 3.145(area under the curve:0.727,95%CI 0.635~0.820,P<0.05).6.As is shown according the Logistic regression analysis that OPN level>4.698mg/L(OR=7.757,95%CI 2.492~24.149,P<0.05)was independent risk factor for poor prognosis in patients with acute cerebral infarction and FIB level>3.145g/L(OR=4.314,95%CI 1.665~11.178,P<0.05)was independent risk factor for poor prognosis in patients with acute cerebral infarction as well.Conclusion:1.The levels of OPN and FIB were positively correlated with the severity and prognosis of cerebral infarction on admission,which was an independent risk factor affecting the severity of cerebral infarction.2.The levels of OPN and FIB had a good predictive value for the prognosis of patients with acute cerebral infarction on admission,and it could be seen that high levels of OPN or high level of FIB indicated poor prognosis.