| ObjectiveIn this study,serum levels of FSTL1,bcl-2,and Bax in patients with Acute cerebral infarction(ACI)were analyzed to analyze the changes in serum and predict the significance of FSTL1 in patients with ACI bleeding transformation,and to evaluate the bleeding in patients with cerebral infarction early,so as to timely intervene and improve the prognosis of patients.Method108 patients with ACI admitted to the Department of Neurology,the First Affiliated Hospital of Xi'an Medical College from 2017-04-01 to 2018-11-01,and 34 gender-and age-matched health check-ups who were in the physical examination of our hospital at the same time were selected.Serum specimens of patients with ACI(on the first day of onset),3days,and 1 week,and fasting serum samples from healthy subjects were collected.The baseline clinical features of all subjects were collected.Serum levels of FSTL1,Bax and Bcl-2 were determined by enzyme-linked immunosorbent assay(ELISA).Patients with acute cerebral infarction were divided into hemorrhagic transformation group(10 cases)and non-hemorrhagic transformation group(98 cases)according to the results of cranial CT reexamination.Kolmogorov-Smirnov test,t test,Mann-Whitney U test,Chi-square test,ANOVA,Person correlation analysis,Spearman correlation analysis,ROC curve and binary logistic regression analysis were used for statistical analysis.Results1.Serum levels of FSTL1 and Bax in patients with ACI increased with the course of disease,which were higher than those in healthy group(P<0.05).The level of Bcl-2decreased with the course of disease,which was lower than that in healthy group(P<0.05).2.The serum FSTL1 level was positively correlated with the severity of ACI patients(P<0.05).3.The serum levels of FSTL1 and Bax in the ACI patients were higher than those in the non-thrombolytic group(P<0.05).The levels of Bcl-2 in the thrombolytic group were lowerthan those in the non-thrombolytic group(P<0.05).4.There were no significant differences in the levels of Bax and Bcl-2 between the different clinical features of ACI patients(P>0.05).There were significant differences in serum FSTL1 levels between patients with different total cholesterol,low-density lipoprotein,coronary heart disease and atrial fibrillation group(P<0.05).There was no significant difference in the level of FSTL1 between the two groups(P>0.05).5.There was no correlation between serum Bax and Bcl-2 levels and different clinical features(P>0.05).FSTL1 level was positively correlated with ACI with coronary heart disease,atrial fibrillation and admission NIHSS score(P<0.05),and serum total cholesterol.There was a negative correlation between level,low density lipoprotein level and uric acid level(P<0.05).6.The levels of serum FSTL1 and Bax in the hemorrhagic transformation group were higher than those in the non-bleeding group(P<0.05),and the serum Bcl-2 level was lower than that in the non-bleeding group(P<0.05).Serum LDL level and admission NIHSS score.There was significant difference between ACI combined with hypertension,diabetes and atrial fibrillation in the hemorrhagic transformation and non-bleeding conversion group(P<0.05).7.Serum FSTL1 level was positively correlated with Bax level in ACI patients,and negatively correlated with Bcl-2 level and Bcl-2/Bax ratio(P<0.05).8.The level of serum FSTL1 >7.41 ng/ml in patients with ACI was the best cut-off value for predicting hemorrhagic transformation(AUC=0.969±0.018,P<0.001,sensitivity:90.00%,specificity: 98.00%);9.Binary logistic regression analysis: Atrial fibrillation and cerebral infarction volume are independent risk factors for hemorrhagic transformation.Conclusion1.Serum FSTL1 may play a protective role in ACI by regulating Bcl-2/Bax.2.The level of serum FSTL1 is positively correlated with the degree of ACI neurological impairment,which may be an indicator of the severity of ACI.3.Serum FSTL1 expression levels were significantly different between the HT group and the non-HT group.4.Atrial fibrillation and cerebral infarction volume are independent risk factors for hemorrhagic transformation. |
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