Relationship Between PCSK9 And The Severity And Prognosis Of Acute Cerebral Infraction

Objective: As an endogenous serine protease synthesized by the liver endoplasmic reticulum,PCSK9 can closely affect the hyperlipidemia,atherosclerosis,insulin resistance and glucose metabolism.[7].Recent studies have focused on the high correlation between PCSK9 level and gene polymorphism with cardiovascular events,and the enhanced lipid-lowering effect of inhibitors.However,rare studies have explored the relationship between PCSK9 and cerebrovascular disease.So,the purpose of this study was to explore the relationship between serum PCSK9 level and the onset of acute cerebral infarction,the dynamic evolution of post-acute concentration,the severity and the short-term prognosis.Methods: The case group included 101 patients selected from patients admitted to the department of neurology of shengjing hospital from December 2017 to January2019.While the control group selected 107 healthy physical examinees during the same period.The level of serum PCSK9 was detected in the same experimental conditions.Meanwhile,Clinical data of all the enrolled patients and the modified Rankin Scale score(mRS)of the case group subjects followed up to the 90 th day after the onse were also collected and grouped for statistical analysis by SPSS software.Results: The proportion of males,hypertension,smoking history,diabetes,,the number of white blood cells,triglyceride,glycosylated hemoglobin,homocysteine and the serum level of PCSK9 in the case group were all higher than those in the control group(P<0.05).Binary Logistic regression analysis results indicated that smoking history,serum PCSK9 level and Hb A1 c were all risk factors of acute cerebral infarction(OR values were all greater than 1,P values were all less than 0.05).As to the severity of the disease,we found the level of PCSK9 in the moderate to severe neurological impairment group(NIHSS > 3 points)was higher than that in the mild group(NIHSS?3 points)(P=0.029),so was the larger infarction group(V?5cm)higer than in the smaller infarction group(V < 5cm)(P=0.001).The serum PCSK9 level?NIHSS score,and infarctvolume of the patients in the poor short-term prognosis group(mRS > 2)were all higher than those in the good short-term prognosis group(mRS ?2 group(P=0.047,P = 0.000;P= 0.010 respectively);Correlation analysis showed that serum PCSK9 level was positively correlated with the infarct volume,NIHSS score,and mRS score(r=0.327,P=0.002,).R =0.535,P = 0.029;R = 0.478,P = 0.000).Conclusion:The serum PCSK9 level of patients with acute cerebral infarction was higher than that of the control group.One week later,the serum PCSK9 level shows a decrease from the admission,but still significantly higher than that of the control group.PCSK9 was positively correlated with the degree of neurological impairment,the volume of cerebral infarction and the prognosis of 90 d.Therefore,serum PCSK9 level may play an important role in the assessment of the severity of acute ischemic stroke and the prediction of short-term prognosis.