Measurement And Clinical Reasearch Of Plasma CLEC-2 And GPVI In Patients With Acute Ischemic Stroke

Objective:Objective to investigate the difference of plasma sCLEC-2 and sGPVI levels between patients with acute ischemic stroke and healthy controls,and the relationship between plasma sCLEC-2 and sGPVI levels and the severity of acute ischemic stroke,different types of acute ischemic stroke and the prognosis of acute ischemic stroke.Methods:We collected 183 patients with acute ischemic stroke(AIS)within 7 days of onset and 149 healthy controls of similar age.The plasma concentrations of soluble glycoprotein VI(GPVI)and C-type lectin like receptor 2(CLEC-2)were measured by ELISA,and the differences of plasma concentrations of sCLEC-2 and sGPVI between the two groups were compared.According to toast classification,the patients were divided into large artery atherosclerosis group and small artery occlusion group;The patients were divided into mild group(< 5 points)and non mild group(≥ 5 points)according to NIHSS score;The patients were divided into good prognosis group(n = 99)and poor prognosis group(n = 50)according to the modified Rankin Scale(MRS)score > 2 at 90 days.Univariate analysis and logistic regression model were used to evaluate the correlation between the plasma levels of sCLEC-2 and sGPVI and the prognosis and related risk factors of stroke.Results:1.There was no significant difference in the general baseline data between the case group and the healthy control group except the drinking rate,which indicated that there was comparability between the two groups;There was significant difference in sGPVI between the two groups(P < 0.05).There was no significant difference in the concentration of sCLEC-2 between the two groups.2.The concentrations of sCLEC-2 and sGPVI were significantly different between patients with NIHSS score ≥ 5 and patients with NIHSS score < 5(P < 0.05),and the concentrations of sCLEC-2 and sGPVI were higher in patients with NIHSS score≥ 5.3.The concentrations of sCLEC-2 and sGPVI were compared between different types of AIS patients and healthy controls.The results of pairwise comparison among the three groups showed that there were statistically significant differences in sCLEC-2: large artery atherosclerosis type and small artery occlusion type,small artery occlusion type and healthy people(P < 0.05);sGPVI: compared with the other two groups,the difference was statistically significant(P < 0.05).4.Single factor analysis of factors affecting the prognosis of AIS showed that age,BMI value,smoking,hypertension,diabetes,hyperhomocysteinemia,hyperlipidemia,atherosclerosis,NIHSS score and other factors all affected the prognosis of patients(P<0.05).5.The multivariate regression analysis showed that age,smoking,hypertension and concentrations of sCLEC-2 and sGPVI were independent risk factors for poor prognosis(P<0.05).Conclusion:1.There was no significant difference in the level of sCLEC-2 between AIS patients and healthy controls;2.The level of plasma sGPVI in AIS patients was significantly higher than that in healthy controls,suggesting that the level of plasma GPVI may be used as an in vivo biomarker for the diagnosis of AIS;3.Plasma levels of sCLEC-2 and sGPVI were correlated with the severity of the disease,suggesting that they may be used as indicators to judge the severity of the disease;4.SCLEC-2 was increased in AIS patients with small artery occlusion,and sGPVI was increased in AIS patients with large artery atherosclerosis;5.Plasma levels of sCLEC-2 and sGPVI may be independent biomarkers for predicting the prognosis of AIS patients.