| Objective: To investigate the correlation between microembolic signal(MES) and Immune inflammatory.Methods: 1.To collect hospitalized patients with acute ischemic stroke in a row. Patients were divided into MES positive group and negative group. Baseline demographic and clinical data were Comparied between the two groups. Independent factors of the MES were determined by Application of multivariate logistc regression analysis. 2. To collect hospitalized patients with acute posterior circulation cerebral infarction in a row. Patients were divided into micro embolus signal positive group and micro embolus signal negative group. Baseline demographic and clinical data were Comparied between the two groups.Independent factors of the micro embolus signal were determined by Application of multivariate logistc regression analysis.3. A total of 222 consecutive elderly patients with cerebral infarction, 146 cases in the control group for the same period in healthy subjects were include in the study.All Were treated with TCD, MES, Treg, CD95, Lp-PLA2 detection.Discussion in multi level groups according to the character of atherosclerotic plaque,the degree of arterial stenosis and the results of MES detection.4.To collect patients with NVAF in a row. Patients were divided into MES positive group and negative group.Baseline demographic and clinical data were Comparied between the two groups.Independent factors of the MES were determined by Application of multivariate logistc regression analysis.Results:A total of 237 patients with acute ischemic stroke were enrolled.52 cases in MES positive group,and 185 cases in negative group.The level of Triglyceride( 2.130±0.933mmol/Lvs. 1.811±0.962mmol/L;t=2.126,P=0.035),Fib(2.946±0.255g/L vs.2.833±0.322g/L; t = 2.332, P = 0.021), Lp- PLA2(288.265±27.855 ng/ml vs.261.652±29.961 ng/ml; t = 2.897, P = 0.004)in the MES positive group were significantly higher than that of the MES negative group. The proportion of CD4+CD25high regulatory T cells(Treg)(8.695±1.461% vs. 9.445±1.397%; t= 3.386, P = 0.001) in the MES positive group was significantly lower than that of negative groups.The proportion of patients with artery stenosis≥70%(21.15%vs.5.41%;X2=10.592, P = 0.001) in the MES positive group was significantly higher than those of negative group. The proportion of small artery occlusive proportionof TOAST classification(9.62%vs. 23.24%; X2= 4.667, P= 0.031) in the MES.positive group was significantly lower than that of MES negative groups. Multivariate logistc regression analysis showed that the high level of Fib(odds ratio [OR] 3.257, 95%confidence interval [CI] 1.124-9.438;P=0.030) and the artery stenosis≥ 70%(OR 3.585,95% CI 1.394-9.219;P=0.008) and the reduced ratio of Treg(OR 3.801, 95% CI1.190-12.148;P=0.024) were the independent risk factors for MES.2.A total of 227 patients with acute posterior circulation cerebral infarction were enrolled. 51 cases in MES positive group,and 176 cases in MES negative group.The level of Fib(2.936±0.258 g/L vs.2.635±0.320 g/L; t = 3.105, P = 0.002), Lp- PLA2(288.265±28.857 ng/ml vs.272.656±29.969 ng/ml; t = 3.302, P = 0.001) in the MES positive group were significantly higher than that of the MES negative group. The proportion of CD4+CD25high regulatory T cells(Treg)(8.595±1.465% vs. 9.345±1.398%; X2= 3.337, P = 0.001) in the MES positive group was significantly lower than that of MES negative groups. The proportion of small artery occlusive proportion(soa) of TOAST etiology classification(9.80%vs. 24.43%; X2=5.001, P= 0.025) in the MES positive group was significantly lower than that of MES negative groups. The proportion of patients with basilar artery stenosis 50%(29.41%vs.4.55%;X2=10.311, P = 0.001) in the MES positive group was significantly higher than those of MES negative group. Multivariate logistc regression analysis showed that the high level of plasma Fib(odds ratio [OR] 6.663, 95% confidence interval [CI] 2.250-19.732; P = 0.001)and the basal artery stenosis 50%(OR 4.805, 95% CI 1.782-12.960; P = 0.002) and the reduced ratio of Treg(OR 5.659, 95% CI 1.750-18.299; P = 0.004) were the independent risk factors for MES in basilar artery of posterior circulation cerebral infarction.3. A total of267 patients with acute ischemic stroke were enrolled.50 cases in MES positive group,and217 cases in negative group.The ratio of patients with diabetes(62.00%vs.20.74%;X2=33.979,P=0.000),The ratio of smoking patients(20.00% vs.8.76%;X2=5.307,P=0.021),Lp-PLA2(275.245±35.865ng/ml vs.262.642±38.941ng/ml; t=2.093,P=0.037),Fib(2.946±0.256g/L vs.2.803±0.302g/L;t=3.100,P=0.002) in the MES positive group were significantly higher than that of the MES negative group. The ratio of anticoagulation patients(8.00%vs.22.58%;X2=5.430,P=0.020) and The proportion of Treg(8.695±1.461% vs.9.445±1.397%; t=3.386, P=0.001) in the MES positive group were significantly lower than that of negative groups. Multivariate logistc regression analysis showed thatsmoking(odds ratio [OR] 4.216, 95% confidence interval [CI] 1.491-11.921;P=0.007) and the level of Fib(OR 2.908, 95% CI 1.189-7.114;P=0.019) and the reduced ratio of Treg(OR 3.368, 95%CI 1.634-6.938;P=0.001) were the independent risk factors for MES.Canticoagulation(OR0.204,95% CI 0.074-0.563;P=0.002)was the independent protective factors for MES.Conclusion: MES may be associated with inflammation.The positive rate of MES,the level of CD95 and Lp-PLA2 were increased,the level of Treg was decreased,Unstable plaque group was more significantly. MES may be associated with inflammation in nonvalvular atrial fibrillation Reducing fiber, protect arteries, immune regulation could help regulate and control micro embolus signal. It is necessary to pay attention to the relationship between stroke and immunity.
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