| Objective: Through detecting the level of serum pregnancy associatedplasma protein (PAPP-A) and oxidized low-density lipoprotein (ox-LDL) inpatients with acute atherosclerotic cerebral infarction (ACI) and transientcerebral ischemic attack (TIA), to explore the relationship between thePAPP-A, ox-LDL and acute ischemic cerebrovascular disease, atherosclerosis,and to explore the relationship between the two markers and high sensitivity Creaction protein (hs-CRP). Furthermore, maybe we can find new bloodmarkers of acute ischemic cerebrovascular disease, and explore therelationship between the level of these markers and the degree of neurologicaldeficit of patients with acute atherosclerotic cerebral infarction (ACI).Methods: We choose90cases of acute cerebral infarction and30casesof transient ischemic attack for study object in inpatients or outpatients in theDepartment of Neurology in the Second Hospital of Hebei Medical University,from2011-04to2011-12. Meanwhile,30cases (with no cerebrovasculardisease history and risk factor) were chosen from medical examination centeras the normal control group and confirmed by CT or MRI. The inclusioncriteria is the diagnostic criteria of acute cerebral infarction which was madeon the Fourth National Cerebrovascular Disease Conference in1995and theclinical definition of transient ischemic attack which was made by AmericanHeart Association (AHA) and American Stroke Association (ASA) in2009.All the cerebral infarction cases were within72hours since onset, andtransient ischemic attack cases were within24hours from the last episodes ofattack. All the patients were confirmed by CT or MRI, and except for cerebralembolism, severe heart diseases, liver, kidneys, blood system diseases, self-autoimmune diseases and with a history of larger surgery or trauma recentlyand so on. The degree of neurological deficits of all the patients with acute cerebral infarction were evaluated with U.S. National Institutes of HealthStroke Scale (NIHSS score). The levels of PAPP-A and ox-LDL in serum weredetected by enzyme-linked immune sorbent assay (ELISA), the levels ofhs-CRP in blood were measured by immune turbidimetry. All the dates wereanalyzed by SPSS13.0.Results:1. The levels of PAPP-A and ox-LDL in serum gradually increased innormal controls, TIA group and ACI group, the differences had statisticalsignificance (P<0.05).2. The serum levels of PAPP-A (7.51±3.39) and ox-LDL (523.36±207.42)in acute cerebral infarction are both higher than the patients with TIA(5.98±2.22and451.00±166.82), the differences had statistically significant.3. The more serious neurologic impairment the higher level of serumPAPP-A, the differences had statistical significance among groups (F=34.581,P=0.001).4. The more serious neurologic impairment the higher level of serumox-LDL, the differences had statistical significance among groups (F=34.653,P=0.001).5. The serum level of PAPP-A and ox-LDL were both positivelycorrelated with levels of hs-CRP in serum (rs=0.791, P=0.000andrs=0.803, P=0.000), which had been proved to be a biomarker ofinflammatory.Conclusion:1. Serum PAPP-A and ox-LDL levels in patients with cerebral infarctionand TIA was higher than that of the normal control group, serum PAPP-A andox-LDL levels in patients with cerebral infarction is higher than that of TIAgroup. PAPP-A and ox-LDL are both blood biomarkers of cerebral infarctionand TIA probably.2. Both PAPP-A and ox-LDL were related with neural functionimpairment, therefore the determination of serum PAPP-A and ox-LDL maybe helpful to judge the severity of ischemic cerebralvascular diseases. 3. PAPP-A and ox-LDL were both positively correlated with of hs-CRP,which has been proved to be an inflammatory biomarker. Meanwhile, PAPP-Apositively correlated with ox-LDL, so we concluded that inflammatory andoxidative stress may be both involved in the formation of atherosclerosis andischemic cerebrvalvascular diseases. |
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