Study On The Correlation Between Serum Cysteine Proteinase-1 And NLRP3 Levels And The Degree Of Cerebral Atherosclerotic Stenosis In Patients With Cerebral Infarction

Objective:Discussion focal cerebral infarction in patients with serum cell death related factors NLRP3,cysteine protease-1(caspase 1)levels and cerebral arteries(outside of intracranial artery atherosclerotic stenosis degree of correlation,in order to against focal death pathways and activating factor in the direction of cerebrovascular disease research to provide the new train of thought,which is new in the treatment of cerebrovascular diseases.Method:Selection in November 2019 to June 2020 for cerebral infarction in chengde medical college affiliated hospital neurology hospital treatment parallel 170 cases of patients with head and neck aorta CTA inspection,according to whether the merger of cerebral atherosclerosis stenosis is divided into two groups,one group of merger,118 cases of cerebral artery stenosis group(experimental group),another group to 52 cases of cerebral artery stenosis group(control group).The 118 patients in the experimental group were divided into mild stenosis group(n = 39),moderate stenosis group(n =25)and severe stenosis group(n = 54)according to the degree of cerebral artery stenosis indicated by the CTA results of the aortic arch of the head and neck.All subjects in the experimental group and the control group received CT angiography(CTA),cranial magnetic resonance MRI+DWI examination.To collect all the subjects of general clinical data such as age,gender,history of drinking,smoking,diabetes,high blood pressure,etc.,as well as inspection,inspection data including: intracranial artery atherosclerotic stenosis degree,blood lipids,blood glucose levels,liver and kidney function,leucocyte count(WBC)and homocysteine(Hcy),etc.According to the degree of cerebral artery stenosis,the patients were divided into three groups: non-stenosis group(<30%),mild stenosis group(30%-49%),moderate stenosis group(50%-69%),and severe stenosis or occlusion group(70%-100%).Serum levels of NLRP3 and Caspase-1 were detected by ELISA,and the results were compared with non-stenosis group,mild stenosis group,moderate stenosis group and severe stenosis group.Spearman correlation analysis was used to investigate the correlation between serum NLRP3,caspase-1 levels and general biochemical indexes and the severity of cerebral atherosclerotic stenosis in patients with cerebral infarction,as well as the correlation between various biochemical indexes and serum caspase-1 concentration and serum NLRP3 concentration.The risk factors of cerebral infarction patients complicated with cerebral artery stenosis were investigated by Logistic regression analysis.Finally,ROC curve was used to evaluate the diagnostic value of serum NLRP3 and caspase-1 levels in cerebral infarction patients complicated with cerebral artery stenosis(cerebral artery stenosis ≥30%).Result:1.The general clinical data between the cerebral infarction group without cerebral artery stenosis and the cerebral infarction combined with each cerebral artery stenosis group showed no statistically significant differences in gender,age,and previous history(all P > 0.05).There were statistically significant differences in the levels of TG,TC,Hcy,ALT,NLRP3 and Caspase-1 among all groups(P < 0.05).Serum NLRP3 and caspase-1levels increased with the severity of stenosis,and the difference was statistically significant(P < 0.05).2.Spearman correlation coefficient analysis showed that serum TG(rs=0.51,P < 0.001),TC(rs=0.36,P < 0.001),Hcy(rs=0.36,P < 0.001),NLRP3(rs=0.84,P < 0.001)and Caspase-1(rs= 0.94,P < 0.001)were positively correlated with the severity of cerebral artery stenosis.Serum ALT(RS =-0.23,P=0.002)was negatively correlated with the degree of cerebral atherosclerotic stenosis.Caspase-1(rs=0.82,P < 0.001),TG(rs= 0.42,P < 0.001),TC(rs =0.21,P=0.02),Hcy(rs=0.27,P < 0.001)were positively correlated with NLRP3.ALT(RS =-0.25,P=0.001)was positively correlated with NLRP3.3.Logistic regression showed that NLRP3(OR=2.852,95%CI:1.007～1.015,P < 0.001),TC(OR=2.925,95%CI: 3.693-46.316,P < 0.001),caspase-1(OR=1.207,95%CI: 1.116-1.307,P < 0.001)were independent risk factors for cerebral artery stenosis in patients with cerebral infarction.4.Receiver-operating characteristic curve(ROC)showed that the area under the evaluation curve for predicting cerebral infarction with cerebral atherosclerotic stenosis(cerebral artery stenosis ≥30%)was 0.93(95%CI:0.95-0.98,P=0.000).The optimal cut-off value was 736 pg/ml,the sensitivity was 84.6%,and the specificity was 93.2%.However,the specificity and sensitivity of caspase-1 in predicting cerebral infarction complicated with cerebral atherosclerotic stenosis were low(< 30%).Conclusion:Serum NLRP3 and Caspase-1 levels were closely correlated with the degree of cerebral atherosclerotic stenosis in patients with cerebral infarction.