Heart Type Fatty Acid Binding Protein And Neuron Specific Enolization Enzyme For Early Diagnosis And Prognosis Evaluation In Acute Cerebral Infarction

Acute cerebral infarction refers to ischemic necrosis or softening of the brain which caused by disorders of brain blood circulation, ischemia and hypoxia and finally ends up with clinical manifestations such as focal depletion defect. The morbidity and mortality of cerebrovascular disease was obviously higher than that of cardiovascular disease in our country compared to western countries. The occurrence of cerebral apoplexy is especially high in north China due to the overdose intake of salt and fat and short of exercise along with long-term adverse lifestyles such as smoking and drinking. The high morbidity and mortality of cerebral apoplexy become personal or families’ or social burden. The mainly diagnosis method of acute ischemic stroke is CT or MRI. However there are some certain limitations about those two examinations. The CT cannot demonstrate the exact responsible infarction within 24 hours of not(unless it is large area cerebral infarction). The DWI of MRI can show responsibility infarction lesions within 2 hours. However, it takes a long time to do the MRI and it sometimes is impossible for some unconsciousness patients and patients who have metal implants inside their bodies and can’t cooperate. The MRI cost a lot and it is not popular for some areas where people live in poverty. A quick serum marker for early diagnosis and disease assessment of acute cerebral infarction is expected. There are brian fatty acid binding protein(B-FABP), heart fatty acid binding protein(H-FABP), S100 B, neuron-specific enolase(NSE), serum cystatin C, glial fibrillary acidic protein and myelin basic protein, homocysteine, etc at home and abroad. As the newly developed serum marker, heart fatty acid binding protein and neuron specific enolization enzyme have a very promising research value. ObjectiveTo discuss the disease evaluation and prognosis of outcome of heart acid binding protein(H- FABP) combined with neuron-specific enolase(NSE) in patients with acute cerebral infarction within 24 hours and observe the relationship among the infarction volume and neurological function score and the heart type fatty acid binding protein combined with neuron-specific enolase. This experiment was aimed to provide clinical data of serological indexes for early diagnosis and prognosis in acute cerebral infarction. Methods 1. 109 cases of patients with acute cerebral infarction(ACI) were selected as observation group and they were divided into three groups: mild group(NIHSS score < 4), medium group(NIHSS score 4-15), severe group(NIHSS score > 15) according to the degree of nerve function defect. 80 cases of transient ischemic attack(TIA) patients were as control group. 2. The H- FABP and NSE were tested before and after treatment respectively. The NIHSS score was applied according to infarction volume measurement from CT or MRI before onset and 14 days after treatment. 3. The concentration difference of H- FABP and NSE during onset and after treatment was compared. The relationship between H- FABP, NSE and cerebral infarction volume, the NIHSS score in ACI group was observed. 4. SPSS17.0 was used for data processing and statistical analysis. The measurement data which accords with normal distribution was described in the form of mean ± standard deviation( x ±s). T test was used between two groups. ANOVA was used among groups. Spearman correlation analysis was applied for correlation test. When value p was over 0.05, the data was statistically significant. Results 1. The H- FABP and NSE were significantly higher than normal in ACI and TIA group. The differences between the two groups were statistical significance(P < 0.01). 2. The H-FABP was higher in ACI group than that in TIA group before the treatment the difference was statistical significance(P < 0.01). The difference of NSE in two groups had no statistical significance(P > 0.05). 3. The relationship among each subgroup in ACI group: H- FABP was higher and higher from mild, moderate, severe subgroup which can also described as the severe group > moderate > mild group. The H- FABP also increased as illness degree aggravated(P < 0.01). The NSE differences had no statistical significance(P > 0.05). 4. The correlation analysis of various index: the H-FABP from onset in ACI group was significantly positively related to NIHSS score and infarct volume(rs = 0.338, 0.246, P < 0.01). The NSE and infarct volume were positively correlated(rs = 0.203, P < 0.05). Infarct volume and NIHSS score from onset was positively correlated(rs = 0.265, P < 0.01). 5. H-FABP and NSE was reduced in ACI group after treatment. The difference was statistically significant(P < 0.05, P < 0.01). H – FABP and NSE were positively related to NIHSS score before and after treatment(rs = 0.665, 0.512, P < 0.01). ConclusionH-FABP and NSE abnormally elevated in patients with acute cerebral infarction and were positively related to how the nerve damaged and infarct volume. The differences of H-FABP and NSE before and after the treatment with were significantly positively related to NIHSS score. H-FABP and NSE can be used as sensitive marker for evaluation and prognosis of outcome in acute brain infarction disease. The combination use of these two indicators can improve the specificity and sensitivity.