| Background:With the aggravation of aging in China,the incidence of cerebrovascular disease is increasing,and acute ischemic cerebrovascular disease（AICVD）is one of the main causes of death and long-term disability in China residents,it includes transient ischemic attack（TIA）and acute cerebral infarction（ACI）.Therefore,it is particularly important to find the evaluation indicators for the severity of ACI patients and the prognosis and outcome of TIA.Objective:By comparing the levels of S-100β protein,cluster of differentiation 147（CD147）and soluble CD40 ligand（s CD40L）in peripheral serum of healthy subjects,TIA patients and ACI patients,and combining the clinical data,laboratory and imaging examination results of patients,to explore the correlation between S-100βprotein,CD147,s CD40 L and the progression of TIA and ACI,thus providing ideas for prevention of transient ischemic attack and acute cerebral infarction.Methods:In this study,284 participants were studied.A total of 171 patients with acute cerebral infarction hospitalized in the Department of Neurology of the Second Hospital of Jilin University from November 2020 to October 2021 were selected as the ACI group,and 83 patients with transient ischemic attack were selected as the TIA group,both of whom met the inclusion criteria,and 30 patients with health subjects in the physical examination center during the same period were selected as the control group.According to the National Institutes of Health Stroke Scale（NIHSS）,patients in the ACI group were divided into 68 cases in the mild neurological deficit group（<5 points）,65 cases in the medium neurological deficit group（5~15 points）and 38 cases in the severe neurological deficit group（>15 points）.According to ABCD3-I score standard questionnaire,patients in the TIA group were divided into 26 cases in the low risk group（0~3 points）,37 cases in the middle risk group（4~7 points）,and 20 cases in the high risk group（8~13 points）.Meanwhile,according to the occurrence of cerebral infarction within three months in the TIA group,the patients were divided into the positive event group（12 cases）and the negative event group（71 cases）.The clinical data,biochemical examination and imaging data of the enrolled patients were recorded in detail,fasting vein blood was collected at 24 hours of admission for patients in the ACI and TIA groups,and blood was collected again on the 7th day of admission for patients in the TIA group（51 of the TIA patients had blood collected twice）.Serum was separated from all samples by centrifugation,enzyme linked immunosorbent assay（ELISA）was used to detect the level of S-100β protein,CD147 and s CD40 L in the serum.Through analyzing the levels of S-100β protein,CD147 and s CD40 L in serum of three groups,and combining NIHSS score,ABCD3-I score and other clinical data,to explore the correlation between S-100β protein,CD147,s CD40 L and the progression of TIA and ACI.Results:1.There was no significant difference between ACI group,TIA group and control group in terms of age and sex（P > 0.05）.There was no significant difference between ACI group and TIA group in history of smoking,drinking,hypertension,heart disease,dyslipidemia and high homocysteine（P > 0.05）,and the proportion of diabetes history in the ACI group was higher than that in the TIA group（P < 0.05）.2.The levels of serum S-100β protein,CD147 and s CD40 L in the TIA group and ACI group were significantly higher than those in the control group,the difference was statistically significant（P < 0.05）.The levels of serum S-100β protein,CD147 and s CD40 L in the ACI group were significantly higher than those in the TIA group,the difference was statistically significant（P < 0.05）.3.The levels of serum S-100β protein,CD147 and s CD40 L in ACI patients with neurological impairment in the mild,medium and severe groups were significantly higher than those in the control group（P < 0.05）,and the comparison between each two groups was statistically different（P < 0.05）.Spearman correlation analysis showed that the levels of serum S-100β protein（r=0.601,P < 0.001）,CD147（r=0.720,P < 0.001）and s CD40L（r=0.626,P < 0.001）were positively correlated with the neurological deficit（NIHSS score）,that is,the more serious the neurological deficit,the higher the serum levels of the three.4.In the TIA group,the levels of S-100β protein,CD147 and s CD40 L in peripheral serum of some patients on the 7th day of admission were significantly lower than those within 24 hours of admission,and the difference was statistically significant（P < 0.001）.5.The serum S-100β protein level of TIA patients in the low risk group,middle risk group and high risk group was higher than that in the control group,and the difference was statistically significant（P < 0.05）.There was no statistical difference in serum S-100β protein level between low risk group and middle risk group（P >0.05）,and the serum S-100β protein level in the high risk group was higher than those in the low risk group and middle risk group（P < 0.05）.The levels of serum CD147 and s CD40 L in the low risk group,middle risk group and high risk group were higher than those in control group（P < 0.05）,and the comparison between each two groups was statistically different（P < 0.05）.Spearman correlation analysis showed that the levels of S-100β protein（r=0.521,P < 0.001）,CD147（r=0.563,P <0.001）and s CD40L（r=0.575,P < 0.001）were positively correlated with the risk stratification of early stroke after TIA（ABCD3-I score）.6.The incidence of cerebral infarction in TIA patients within 3 months was7.69%（2/26）in the low risk group,10.81%（4/37）in the middle risk group,and30.00%（6/20）in the high risk group,there was no statistical difference among groups（P > 0.05）.There was no significant difference in serum S-100β protein level between the positive event group that developed cerebral infarction within 3 months after the disease onset in TIA patients and the negative event group（P > 0.05）,and the levels of CD147 and s CD40 L in the positive event group were significantly higher than those in the negative event group（P < 0.01）.7.To evaluate the diagnostic efficiency of serum CD147 and s CD40 L levels in early stroke after TIA,receiver operating characteristic（ROC）curve analysis showed that the areas under the curve of serum CD147 and s CD40 L levels were0.763 and 0.738,respectively,and the optimal thresholds were 91.770 and 2.815,respectively,and their sensitivities were 91.7% and 91.7%,respectively,and their specificities were 60.6% and 52.1%,respectively.Conclusion:1.The levels of serum S-100β protein,CD147 and s CD40 L in patients with acute cerebral infarction were significantly increased and positively correlated with the degree of neurological impairment（NIHSS score）,which have important clinical guiding significance for evaluating the severity of the disease.2.The levels of serum S-100β protein,CD147 and s CD40 L in patients with TIA were increased,which were positively correlated with the risk stratification of early stroke（ABCD3-I score）.Among them,CD147 and s CD40 L have high diagnostic efficiency in evaluating early stroke after TIA,which could be used as risk factors for TIA and a biological indicator for predicting early stroke. |
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