| Objective : Cerebral infarction(CI)has the characteristics of high incidence and disability in China,which places significant burden on society and families.Trimethylamine N-oxide(TMAO)can promote atherosclerosis(AS),activate platelets and increase the risk of thrombosis.It is associated with various diseases such as CI and coronary atherosclerotic heart disease,but its clinical research in CI is still controversial.This article aims to understand whether TMAO will change dynamically during the acute phase and recovery phase of CI through the correlation study and detection methods of TMAO in CI patients,and at the same time understand the relationship between CI risk factors and TMAO.Materials and methods:1.Patients with acute stroke hospitalized in the Department of Neurology,affiliated Hospital of Hebei University from October 2018 to September 2019 were selected.The first fasting plasma sample(TMAO1)was taken on the day of admission or in the early morning of the second day.The samples of all patients were collected within 3days of onset.According to the inclusion and exclusion criteria for strict screening,qualified cases were finally diagnosed as cerebral infarction(CI)and included in the follow-up analysis.2.(1)Collect the patient’s general data,past history and laboratory data;the time of reexamination was the 30 th day of the disease,and the fasting plasma samples(TMAO2)and oral drug status of the patients were collected.(2)All qualified cases followed the diagnostic criteria of Chinese guidelines for diagnosis and treatment of Acute Ischemic Stroke 2018,and diffusion weighted imaging(DWI)showed high signal intensity.(3)The locations of the lesions on DWI were recorded and the maximum lengths and diameters were measured,and the patients grouped according to the circulation distribution,infarct size and National Institutes of Health Stroke Scale(NIHSS)score.(4)The results of enzyme-linked immunosorbent assay(ELISA)and ultra-high performance liquid chromatography tandem mass spectrometer(UPLC-MS)were compared,and observe whether the two methods are consistent.SPSS 23.0 statistical software was used to select the corresponding statistical methods to analyze all the data.Results:1.The study finally included 90 patients with CI who met the criteria.Amongthem,59 were male and 31 were female.The average age of the patients was(60.23±8.32)years.2.This study conducted a Wilcoxon rank-sum test analysis of the changes in the TMAO acute and recovery phases of CI patients and found that TMAO2 in CI patients was significantly lower than TMAO1,and the difference was statistically significant(P<0.001)3.Multiple linear regression analysis showed that oral aspirin within one week could reduce logTMAO1(β=-0.365,P<0.001),elevated total cholesterol increases logTMAO1(β=0.242,P=0.016).4.The TMAO2 of patients without oral aspirin was significantly lower than that of TMAO1(P=0.001),and there was no significant difference between TMAO2 and TMAO1 in oral aspirin group(P=0.064).5.The results showed that there was no significant difference in TMAO1 among different circulatory distribution,infarct size and stroke severity(P>0.05).6.The variation of TMAO value detected by ELISA was large,which was statistically different from the UPLC-MS method.Conclusion:1.There were dynamic changes of TMAO in different periods of CI,which may be related to oral asprin.2.Oral aspirin can reduce the level of TMAO,and the increase of total cholesterol can increase the level of TMAO.3.There was no significant correlation between plasma TMAO and circulatory distribution,infarct size and stroke severity of cerebral infarction.4.The results of quantitative detection of human plasma TMAO by ELISA method were not consistent with UPLC-MS method. |
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