Study On The Correlation Between NMDA, UFDP And Phlegm - Heat Syndrome, Clinical Efficacy Evaluation And Prognosis In Stroke Patients Based On Biological Sample Database

Objective:This study tried to build a large-scale,high-quality,standardized stroke traditional Chinese medicine(TCM) syndrome biobank to meet requirements of stroke sciences studies that the massive ischemic stroke biological samples. Based on this biobank,we had explore the relevance between biomakers NMDA,UFDP and the diagnosis of phlegm-heat syndrome,clinical efficacy evaluation,prognosis of ischemic stroke.Methods:Referencing to domestic and foreign constructing standardization and management experience in their biobanks,we initially constructed the stroke TCM biobank.Based this biobank, we randomly selected 60 cases stroke patients with phlegm-heat syndrome(the control group:30 cases,the test group:30 cases).The control group was given the basic treatment of Western medicine,the test group was given the basic treatment of Western medicine and Angongniuhuang pill,the biomarkers NMDA,UFDP was collected from patients within 72h of onset and day 7 and day 14 after onset,at the same time, the NIHSS(National Institutes of Health Stroke Scale) scores and phlegm-heat scores were acquired as recent disease and syndrome evaluation with NIHSS and ISTSFES(Ischemic Stroke TCM Syndrome Factor Evaluation Scale),and the BI scores was acquired as long-term outcomes evaluation.In addition,this study included 63 cases healthy people,the biomarkers NMDA,UFDP was collected at the day when they be included.Results:① This study has initially constructed a stroke TCM biobank.②Correlation between serum NMDA,UFDP and phlegm-heat syndrome in acute ischemic stroke:the result show significant differences in serum NMDA between healthy people and the patients within 72h of onset(P=0.005<0.05),day 7 (P=0.002<0.05) and day 14(P=0.002<0.05) after onset.Receiver operator characteristic curves(ROC) analysis show that NMDA exhibited certain diagnostic accuracy at the three time point with an AUC of 0.65,0.67,0.67,respectively, and sensitivity of 64.90%,specificity of 78.3%,80%,80%.The cut-off values of serum NMDA level for the diagnosis of phlegm-heat syndrome at the three time points were 11.75ng/ml,12.10ng/ml,12.03ng/ml respectively.The result failed to show significant differences between the healthy people and the patients at the three time points(P=0.865>0.05,P=0.737>0.05,P=0.253>0.05).ROC analysis show that diagnostic accuracy of UFDP at the three time point with an AUC of 0.51,0.52,0.57, sensitivity of 17.00%,23.40%,38.30%, and specificity of 100%,95.00%,88.30%.The cut-off values of serum UFDP level for the diagnosis of phlegm-heat syndrome at the three time points were 99.85ng/ml,81.70ng/ml,70.90ng/ml.③Correlation between biomarkers NMDA,UFDP levels and treatment efficacy evaluation in stroke patients:correlation analysis between changes of within 72h of onset and day 7 after onset serum NMDA,UFDP levels and NIHSS scores,phlegm-heat syndrome scores show that：in the control group,the serum NMDA level was not significantly associated with NIHSS socres(r=0.014,P=0.942> 0.05),phlegm-heat syndrome scores(r=0.013,P=0.949> 0.05);the serum UFDP level was not significantly associated with NIHSS scores(r=0.031,P=0.889>0.05),phlegm-heat syndrome scores(r=0.003,P=0.988>0.05).In the test group,the serum NMDA level was not significantly associated with NIHSS socres(r=-0.090,P=0.649>0.05),phlegm-heat syndrome scores(r=0.O58,P=0.649>0.05);the serum UFDP level was not significantly associated with NIHSS scores(r=-0.078,P=0.715>0.05),phlegm-heat syndrome scores(r=0.141,P=0.511>0.05).④Correlation analysis between serum NMDA,UFDP levels with prognosis:the correlation analysis of serum NMDA,UFDP levels within 72h of onset and recent,long-term prognosis of disease show that:the NMDA level was not significantly associated with NIHSS scores(r=-0.124,P=0.368>0.05),phlegm-heat syndrome scores(r=-0.040,P=0.774>0.05),and BI scores(r=0.089,P=0.519>0.05);the UFDP level was not significantly associated with NIHSS scores(r=-0.004,P=0.978>0.05), phlegm-heat syndrome scores(r=0.125,P=0.414> 0.05),and BI scores(r=-0.119,P=0.436>0.05).Conclusions:serum NMDA levels have some diagnostic value for phlegm-heat syndrome in ischemic stroke within 72h of onset,day 7 and day 14 after onset.The serum NMDA,UFDP levels did not show a significant correlation with treatment efficacy evaluation and prognosis.However,the serum NMDA,UFDP levels exhibited a converse tendency between the control group and the test group,which indicates the correlation between NMDA,UFDP and treatment efficacy evaluation deserving further exploration.