Correlation Between Bilirubin,Omentin-1 And The Formation Of Collateral Circulation In Patients With Ischemic Stroke Based On ASL

BackgroundIschemic stroke has the characteristics of high morbidity,high mortality,high disability rate and high recurrence rate.Good collateral circulation can supply blood and improve blood perfusion when cerebral ischemia infarction occurs.The evaluation of collateral circulation is the key to deepen clinical research and improve therapeutic effect.Arterial spin labeling(ASL)and digital substraction angiography have good consistency in evaluating collateral circulation.Bilirubin has been shown to be an important protective factor for peripheral blood vessels,coronary arteries and carotid atherosclerosis.Omentin-1 affects the state of blood vessel walls and participates in the regulation of atherosclerosis.ObjectiveTo investigate the relationship between bilirubin,omentin-1 and ischemic cerebral collateral circulation.MethodsFrom April 2019 to November 2020,70 patients with ischemic stroke who were hospitalized in the first affiliated Hospital of Xinxiang Medical University were selected.The onset time was within 7 days.Clinical data were continuously recorded for all subjects,including sex,age,smoking history,drinking history,bilirubin level,risk factors of major cerebrovascular diseases(hypertension,diabetes,hyperlipidemia,heart disease).The MR750 superconducting magnetic resonance imager is used in this study.The scanning sequence includes: axis DWI,ASL,T1 WI,T2WI,T1 FLAIR,MRA sequence,and the original map is obtained by using Functool software to process the ASL image.Patients were evaluated by ASL and divided into good collateral circulation group(27 cases)and the poor group(43 cases)according to whether there was dot and strip hyperperfusion signal around the infarct core area in the original map;the CBF values between the two groups were compared,as well as in the same group in different PLD.The concentration of omentin-1 in blood was determined by ELISA.Statistical analysis was performed using SPSS25.0 software.Results1.There was no significant difference in CBF value between the two groups PLD=1.5s(P>0.05).When PLD=2.5s,the CBF value of infarct area in both groups was higher than that of PLD=1.5s,and the CBF and △CBF value of the infarct area in the good group were higher than those in the poor group(P<0.05).2.There was no significant difference in the concentration of total bilirubin,direct bilirubin and indirect bilirubin between the two groups(P>0.05).Omentin-1 in the good group was significantly higher than that in the poor group,and the difference was statistically significant(P<0.05).3.The area under the curve drawn by omentin-1 level is 0.733,the 95% confidence interval is(0.611-0.855),P=0.001,the true positive rate is 0.630,and the alse positive rate is 0.814.Youden index is 0.44,and the corresponding threshold for omentin-1 levels was68.15 ng/mL.4.Spearman correlation analysis showed that omentin-1 was positively correlated with the formation of cerebral collateral circulation(r=0.393,P<0.05).However,total bilirubin,indirect bilirubin,and direct bilirubin have no correlation with the formation of cerebral collateral circulation(P>0.05).ConclusionASL technology with dual PLD can effectively evaluate the blood perfusion in the cerebral infarction area under different collateral circulation states;bilirubin is not significantly associated with the formation of collateral circulation in ischemic stroke;omentin-1 is associated with the formation of collateral circulation in ischemic stroke,which is helpful to evaluate the formation of cerebral collateral circulation.