Expression Level Changes And Clinical Significance Of HO-1,SOD In Patients With Acute Large Artery Occlusion Cerebral Infarction Following Reperfusion After Endovascular Therapy

Objective:Aim to determine the levels of serum heme oxygenase-1(HO-1)and superoxide dismutase(SOD)in patients with Acute large artery occlusion cerebral infarction(LAO-ACI)before and after recanalization of endovascular therapy(EVT).The changes of serum HO-1 and SOD levels and their correlation with the severity of cerebral infarction,recanalization level of responsibility vessels and postoperative bleeding transformation were analyzed.Objective to explore the related biomarkers for endovascular therapy of acute large artery occlusion cerebral infarction.Methods:From November 2018 to September 2019,29 patients coming from department of Neurology,Sichuan Provincial People’s Hospital,with acute large artery occlusion cerebral infarction who received endovascular therapy[including thrombectomy with stentrievers and thromboaspiration] and responsibility vessels successfully recanalized [the recanalization standard is Modified Thrombolysis in Cerebral Infarction Score(m TICI)≥ 2B] were included as the observation group.In addition,22 patients with Digital Substraction Angiography(DSA)in the same period were selected as the observation group [DSA results exclude the presence of head and carotid artery lesions].The fasting blood samples were collected before operation and 1,3,7days after operation in the observation group,also before and after Digital Substraction Angiography examination in the control group,and the serum was extracted by centrifugation.The serum levels of HO-1 and SOD in each group were detected by enzyme linked immunosorbent assay.The serum levels of HO-1 and SOD in the two groups were compared.,and the correlation between the levels of serum HO-1,SOD and the severity of cerebral infarction,the level of responsiblility vessels recanalization and the hemorrhagic transformation were analyzed.Results:(1)There was no significant difference in age,gender,history of hypertension,diabetes and hyperlipidemia between the two groups(P>0.05).(2)Compared with the control group,the serum HO-1 level in the observation group was significantly higher(P<0.05),and further increased on the 7th day after endovascular therapy compared with preoperation and the 1st day after operation(P<0.05);And the serum SOD concentration of acute cerebral infraction patients decreased significantly(P<0.05),and increased to the level of control group on the 7th day after endovascular therapy(P<0.05);there was no significant difference in serum HO-1,SOD before and after Digital Substraction Angiography examination(P>0.05).(3)Before endovascular therapy,the serum level of HO-1 and SOD in acute cerebral infraction patients with Alberta stroke program early CT(ASPECT)score ≤ 7 was higher than that in patients with ASPECTS score > 7(P<0.05).There was a negative correlation between ASPECTS score and preoperative HO-1,SOD level(r=-0.560,p=0.002;r=-0.552,p=0.004).(4)Preoperative serum HO-1and SOD level in patients with National Institutes of Health stroke scale(NIHSS)score≤12 was significantly lower than that in patients with NIHSS scores>12 in the observation group(P<0.05).And the Preoperative serum HO-1 and SOD level were positively correlated with the NIHSS scores(r=0.633,p=0.001;r=0.569,p=0.001).(5)There was no difference in serum HO-1,SOD level between m TICI2 B group and m TICI 3 group(p>0.05),but for acute cerebral infraction patients with m TICI 3,the serum HO-1,SOD level on the 7th day after endovascular therapy was higher than the 1st day(p<0.05).(6)On the 3rd and 7th day after endovascular therapy,the level of serum HO-1 in the bleeding group was higher than the non bleeding group(P<0.05),and the level of serum SOD was lower in bleeding group on the 7th day.Conclusion:The level of serum HO-1 increases in acute cerebral infraction patients,and it will further increase after successful endovascular therapy.What’s more the serum SOD level reduces and increases to normal level after endovascular therapy.The level of serum HO-1,SOD of acute large artery occlusion cerebral infarction patients is closely related with early infarct degree before endovascular therapy,degree of neurological deficit before endovascular therapy.recanalization level after endovascular therapy and hemorrhagic transformation after endovascular therapy.It is expected to be the effective biomaker of treatment decision-making,recanalization evaluation and complications monitoring of endovascular therapy in acute large artery occlusion cerebral infarction patients.