Study On The Relationship Between Cerebral Small Vessel Disease And Related Biological Markers Of Coagulation-fibrinolysis System And Endothelial Cells

Objectives of the study:In this study,the detailed data of patients with CSVD were collected,and the biological markers of coagulation and fibrinolysis system and the activating factors of endothelial cells were analyzed.It explores the role of coagulation-fibrinolysis system in the occurrence and development of CSVD,and the correlation between biological markers and CSVD.Research methods:From October 2016 to December 2017,60 patients with CSVD who were hospitalized in the first Hospital of Jilin University were selected as group B,and the patients should meet the criteria set by the Institute.There were 30 patients who had no acute events within one month in group B1 and 30 patients who had in group B2.30 healthy people with matching age and sex were selected as control group A at the same time.Basic clinical information was collected and necessary auxiliary examinations were performed on all patients.The examine of serum fibrinogen and tissue plasminogen activator(T-PA)D-dimer and von Willebrand factor(vWF),Intercellular adhesion factor-1(ICAM-1)were conducted.The neuropsychological evaluation was carried out by the neurologist,and the results were analyzed by statistical method.Results:There was no significant difference in sex,age,smoking history and family history of stroke between the two groups.There were significant differences in the history of hypertension,diabetes and ischemic heart disease between the two groups.Among the basic biochemical indexes,there was a significant difference between the two groups in high density lipoprotein cholesterol and uric acid.The group CSVD was significantly higher than the normal control group.Among the biological indexes studied,all the indexes were significantly different between the two groups.It indicated that the above indexes were significant for disease indication.The small cerebral vascular disease group was divided into group B1(No acute event in 1 months)and group B2(Patients with acute events within 1 months).The independent sample t test is used to compare the differences between the two groups,that is,whether the occurrence of acute events has an un-negligible effect on the fluctuation of laboratory indexes.The results showed that the occurrence of acute events had a great influence on ICAM-1 and should not be ignored.The results of correlation between ICAM-1 and cognitive scale and imaging in group B1 were as follows: For group B1(group CSVD,30 patients without acute phase),the serum ICAM-1 level was negatively correlated with MMSE,orientation and language ability.There was a low negative correlation with MSE and MOCA.There was a moderate negative correlation between the nomenclature and MOCA.Serum ICAM-1 level in group B1.1(Mild),group B1.2(Moderate)and group B1.3(Severe)are of an overall difference.Serum ICAM-1 levels were significantly different between group B1.1 and B1.2,but not between group B1.2 and B1.3.The correlation of fibrinogen,T-PA,D-dimer and vWF with cognitive scale and imaging of group CSVD(group B)are in the following.The level of serum fibrinogen was positively correlated with the low degree of MMSE orientation and the low degree of MOCA language.The serum D-dimer level was negatively correlated with the low degree of MOCA subdivision.There was no correlation between serum VWF level and the scale.Serum T-PA level was negatively correlated with MMSE,language subdivision,MES and MOCA.There was a moderate negative correlation with the visual spatial subdivision of MOCA and a negative correlation with the low degree of the directional subdivision.group B(All patients with small cerebrovascular disease)was divided into group C1(Mild),C2(Moderate)and C3(Severe)according to imaging severity.In order to avoid the confusion with the original group B1 and B2,group C was set as a subset of another classification method in group B.The results showed that the serum T-PA level has an overall difference among group C1,C2 and C3..Conclusion:1.Hypertension,diabetes,history of ischemic heart disease,high density lipoprotein cholesterol and uric acid are related to the occurrence of CSVD.2,ICAM-1,vWF,fibrinogen,D-two dimer and T-PA serum level may be related to the pathogenesis of CSVD.3.ICAM-1 was significantly influenced by CSVD acute events;T-PA was less affected by CSVD acute events,and might be more suitable for CSVD serological markers.4.In patients with cerebral small vessel disease,the level of ICAM-1 and T-PA is negatively correlated with the overall score of cognitive scale.5.In patients with cerebral small vessel disease,the level of ICAM-1 and T-PA is correlated with the severity of imaging.