| Background:Cerebrovascular disease is one of the major diseases that harm the health and life of the middle-aged and the elderly.In recent years,stroke has moved forward in the whole cause of death in China.The third national cause of death survey published by the Ministry of health in 2008,stroke(136.64/10 million)has exceeded malignant tumor to become the first cause of death in China.Stroke is also the highest rate of disability in single disease.The high incidence of the disease,the high mortality rate and the high rate of disability bring heavy burden and pain to the society and the family.Early diagnosis of cerebrovascular disease is essential for the selection of the treatment scheme,the reduction of the disability and the improvement of the prognosis.Due to the existence of reflow time window,the most effective way to rescue acute ischemic cerebral infarction is super early thrombolysis and endovascular interventional treatment.The earlier the time,the better the curative effect is,the less incidence of reperfusion injury,secondary hemorrhage and cerebral edema.But within 6 h of the disease(super early)CT did not fully display the infarct.Ischemia modified albumin(IMA)is a sensitive marker of ischemic disease.It can be detected after a few minutes of ischemia.Therefore,IMA has the characteristics of ideal markers.Current studies focusing on IMA have focused on acute coronary syndromes and have elucidated the possible mechanism by which tissue ischemia/reperfusion causes elevated serum IMA levels:local blood perfusion and reduced oxygenation when various causes cause ischemia,Anaerobic metabolism of tissue cells,accumulation of metabolites(such as lactic acid),resulting in acidosis,local microenvironment PH value decreased by the oxygen reaction to generate superoxide radical(O22-),under the action of superoxide dismutase Hydrogen peroxide(H2O2),metal ions in the presence of H2O2 by reaction to form hydroxyl radicals(OH-),human serum albumin(HSA)vulnerable to OH-damage,the N-terminal amino acid sequence changes,the formation of IMA.Some domestic and foreign scholars have shown that IMA can be used as a sensitive serum biochemical marker for early diagnosis of acute myocardial ischemia.The US Food and Drug Administration(FDA)has approved the use of IMA as a biochemical marker for early diagnosis of myocardial ischemia.In-depth study of IMA found that IMA increased blood in other tissue ischemia such as cerebral ischemia(stroke),end-stage renal disease,cirrhosis,certain serious infectious diseases and blood in some advanced cancer patients.Some studies have pointed out that the concentration of serum IMA affected by many factors,and serum albumin,blood lipids are closely related.At present,there are few reports on the correlation between IMA and acute cerebrovascular disease in China.Objectives:To study the relationship between ischemia-modified albumin(ischemia modified albumin)and acute cerebral infarction(acute cerebral hemorrhage),and to summarize whether the elevated ischemia-modified albumin(ischemia modified albumin)in serum can be a sensitive marker of the damage of cerebral neurons and glial cells when ischemia and hypoxia damage occur.Can ischemia modified albumin provide a certain basis for.in the early diagnosis and differential diagnosis of acute cerebral infarction and acute cerebral hemorrhage.Methods:134 cases of acute cerebrovascular disease(Acute cerebrovascular disease)were collected from the emergency department of Affiliated Hospital of Yan’an University,Department of neurosurgery and neurology department,and the blood was collected from the patients with acute cerebrovascular disease(Acute),and the time of onset to blood collection was recorded.The blood collection was related to basic blood,urine and feces,liver and kidney,electrolyte,head imaging and so on.All patients underwent detailed medical history and physical examination.According to the results of CT,MRI and DWI,134 patients were enrolled.1.the 134 patients with acute cerebrovascular disease(24h)collected from 2016.12 months to 2017.12 months were divided into 2 groups,namely,63 cases of acute cerebral infarction(Acute cerebral infarction)and 71 cases of acute cerebral hemorrhage(Acute cerebral hemorrhage).60 cases of the same time stage were selected for ischemic modification in our hospital.Serum Ischemia modified albumin level was detected to compare the Ischemia modified albumin level between the three groups.2.it was divided into 6 hours group,42 cases,12 hours group,24 hour group 53 cases.We used albumin cobalt binding test(Albumin cobalt binding assay test)when the concentration of Ischemia modified albumin was detected.All the serum samples were 2.5 after collecting blood.Within the hour,the three groups were compared.3.of the 134 patients with acute cerebrovascular disease collected from 2016.12 months to 2017.12 months,the patients were selected in 6h,which were divided into 2 groups,20 cases of acute cerebral infarction(Acute cerebral infarction),and 22 cases of acute cerebral hemorrhage(Acute cerebral hemorrhage)group.After admission,the patients were selected within 6h,6～12h,12～24h,respectively.The serum level of ischemic modified albumin(Ischemia modified albumin)was detected at 5 ml in the elbow vein in 2.5 hours,and the changes in the serum level of the ischemic modified albumin(Ischemia modified albumin)were observed with the change of time.To further explore the changes in the level of ischemic modified albumin(Ischemia modified albumin)level in patients with acute cerebral infarction(Acute cerebral infarction)and acute cerebral hemorrhage(Acute cerebral hemorrhage)within 24 hours.Results:1.Acute cerebral infarction,acute cerebral hemorrhage,gender composition of healthy control group,age distribution,hypertension,diabetes,and people who drink and smoke.Visible male 33 cases of acute cerebral infarction group and 30 cases of female acute cerebral hemorrhage group of 33 cases of male 38 cases,female,male 31 cases of healthy controls and 29 cases,three groups,merge into the object in age diseases(hypertension,diabetes)had no statistical difference(P>0.05);There was no statistically significant difference between the three groups in the combination of smoking,drinking and other bad habits of life(P>0.05).2.24 hours of acute cerebral infarction group,the acute cerebral hemorrhage group and healthy control group between serum Ischemia modified albumin(Ischemia modified albumin)level of concentration difference(P<0.05),Ischemia modified albumin(Ischemia modified albumin)concentration levels:In the Acute cerebral infarction group,the Acute>cerebral hemorrhage group and the healthy control group(P<0.05),and the b1 healthy control group of the Acute cerebral hemorrhage group(P<0.05).3.In different groups,Acute cerebrovascular disease is less than or equal to 6h,6h<Acute cerebrovascular disease is less than or equal to 12h,and 12h<Acute cerebrovascular disease is less than or equal to 24h),Ischemia modified albumin in patients with Acute cerebral infarction was(80.64 + 2.24,84.70 + 3.62,78.12 + 3.23),respectively.Patients with Acute cerebral hemorrhage(Acute cerebral hemorrhage)of Ischemia modified albumin(Ischemia modified albumin)value respectively(72.73 +72.73 +/-2.34,3.14,65.21 +/-3.57),were higher than in Acute cerebral hemorrhage(Acute cerebral hemorrhage)patients(all P<0.05),the difference was statistically significant.o4.Visible with the passage of time,the different time points of Acute cerebral infarction(Acute cerebral infarction)patients between 0～12 h,Ischemia modified albumin(Ischemia modified albumin)level of serum concentration increased,between 12～24 h,Ischemia modified albumin(Ischemia modified albumin)level of serum concentration gradually reduce;Patients with Acute cerebral hemorrhage(Acute cerebral hemorrhage)equally between 0～12 h,Ischemia modified albumin(Ischemia modified albumin)level of serum concentration increased,between 12～24 h,Ischemia modified albumin(Ischemia modified albumin)level of serum concentration gradually reduce,However,the overall level of Ischemia modified albumin in the Acute cerebral infarction group was higher than that in the Acute cerebral hemorrhage group within 24 hours.With the extension of time,the serum Ischemia albumin values of patients with Acute cerebral infarction were(80.64 + 2.24,84.54 modified + 3.46,78.62 + 3.20),respectively.The Ischemia modified albumin values of patients with Acute cerebral hemorrhage were(72.47 + 2.31,75.96 + 3.08,64.84 + 3.54),and the F value was 16.02 and P was 0.001,indicating statistically significant differences.Conclusions:1.The levels of IMA in patients with ACI and ACH were higher than those in healthy controls.IMA can be used as a non-specific biochemical predictor of ischemic sensitivity in brain tissue.2.Acute cerebrovascular disease(ACD):serum IMA concentrations within 6 hours of ACI group and ACH group were all between 0 and 12 hours.IMA serum levels gradually increased,between 12 and 24 hours,IMA serum levels.The concentration of serum IMA in the ACI group was higher than that of the ACH group within 24 hours.The serum level of IMA can be used as a new method to assist the differential diagnosis of acute cerebral infarction and acute cerebral hemorrhage.3.Ischemia modified albumin can be used as a serological marker for early diagnosis and assisted diagnosis of acute cerebral infarction and acute cerebral ischemia. |
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