| Objective: The angiopoietin-like protein 2(Angptl-2)is a key factor in the process of atherosclerosis.The Recent studies have found that the serum levels of Angptl-2 elevates markedly in acute coronary syndrome,highly correlated with diabetic macroangiopathy,but the relationship with cerebrovascular disease is still shallow.The aim of this study was to investigate the relationship between Angptl-2 and acute cerebral infarction,TOAST classification,severity of illness,short-term prognosis and carotid atherosclerosis,and the dynamic change of Angptl-2 before and after stroke.Methods: A total of 191 patients with acute cerebral infarction who were treated in our hospital from December 2015 to January 2017 were enrolled in this study as case group;a total of 104 patients with carotid artery with plaque and stenosis but acute cerebral infarction,as atherosclerosis group;the same period of 121 healthy subjects as the control group;and the case group after 10 days of onset in the hospital,which cooperated with the reviews,as a review group,a total of 151 patients.The serum levels of Angptl-2 were measured and the clinical data of the patients were collected and grouped and analyzed according to the requirements.Results: The level of serum Angptl-2 in the case group was significantly higher than that in the controls and the atherosclerosis group.The levels of serum Angptl-2 decreases from the case group,atherosclerosis group and the control group and the difference was statistically significant(P<0.001,P=0.026).Compared the review group with the corresponding case group,atherosclerosis group and the control group,the level of serum Angptl-2 in the review group was lower than those in the cases(P=0.002),and higher than that in the controls(P<0.001),and there was no statistics significance between the review group and the atherosclerosis group(P=0.582).The logistic regression analysis showed that Angptl-2 was an independent risk factor for acute cerebral infarction(OR=5.028,95%CI=2.578-5.819,P<0.001).According TOAST subtypes,the level of serum Angptl-2 in patients with large arterial atherosclerotic cerebral infarction was higher than that in patients with small arterial occlusion(P<0.001).In the case group,there was a positive correlation between NIHSS score and intracranial infarction lesionvolume and serum Angptl-2 level.(r=0.383,P<0.001,r=0.589,P<0.001);the level of serum Angptl-2 in unstable carotid plaque group was higher than non-unstable carotid plaque group(P<0.001).We found a positive correlation between the degree of carotid artery stenosis and level of serum Angptl-2 with the comparison in unstable and non-unstable carotid plaque groups respectivelt.(r=0.275 p=0.029;r=0.614,p<0.001)The difference value of NIHSS score between the case group and corresponding review group was positively correlated with the degree of serum Angptl-2 concentration(r=0.56,P<0.001).Conclusions: The levels of serum Angptl-2 were significantly increased in patients with acute cerebral infarction,therefore Angptl-2 may be an independent risk factor for acute cerebral infarction;Angptl-2 was relevant to stroke subtype,infarct volume,neurological deficit,atherosclerotic plaque type and carotid artery stenosis;and the more severe the disease,the more obvious serum levels increased,Angptl-2 was significantly increased in the early stage of acute cerebral infarction,and then decreased after the acute phase,the decreased level of Angptl-2 has no difference with atherosclerosis group,but remained higher than that of the normal population;After the acute phase,the reduction of Angptl-2 is associated with short-term prognosis.Angptl-2 level in serum of the atherosclerosis group was higher than that of the healthy control group,and the elevated Angptl-2 level suggests atherosclerosis reaction..Angptl-2 can be a biological marker to predict serious degree of pathogenetic and recovery of neurologic impairment,in the meantime,it can be measured to monitor atherosclerosis progress. |
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