Study Of Correlaiton Between Level Of Plasma Asymmetric Dimethylarginine And Acute Cerebral Infarction

Objective: This study was designed to test level of plasma asymmetricdimethylarginine(ADMA) of subjects,to explore the correlation of level of plasmaADMA with infarction areas and the degree of nervous function defect in acute cerebralinfarction(ACI);and to explor correlation of level of plasma ADMA with levels of bloodlipid,glycosylated hemoglobin, hypersensitive c-reactive protein and homocysteine,folic acid such as biochemical indicators of patients with acute cerebral infarction.So asto provide a kind of indicators to judge patient’s condition for clinical and to explorenew preventive and therapeutic targets for ischemic stroke.Method:1.Choose total of186cases conforming to the standard fromDecember2012to June2013, the Affiliated Lian yungang Hospital of BengbuMedical College,patients with acute cerebral infarction in Department ofNeurology and healthy physical examination of a medical center at thesame period.According to different infarction areas,126patients with acute cerebralinfarction were divided into four subgroups:lacunar infarction,small,median and largeinfarction.The degree of neurological defect was evaluated by the U.S.national institutesof health stroke scale(NIHSS scores).Patients were divided into three subgroups basedon different scores:light/midsize/severe cerebral infarction.At the corresponding period,there were60healthy subjects in control group.2.Measurements:Level of plasmaADMA was detected by enzyme-linked immunosorbent assay(ELISA),while detectedtriglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high densitylipoprotein cholesterol (HDL-C), glycosylated hemoglobin, hypersensitive c-reactiveprotein and serum homocysteine, folic acid, routine blood clot and the function of liverand kidney of all subjects,and recorded the age, gender and high blood pressure,diabetes, smoking history, and so on.3.Compared levels of plasma ADMA amonggroups;analyzed the correlation of level of plasma ADMA with infarction areas and thedegree of nervous function defect;expored correlation of level of plasma ADMA withlevels of blood lipid,glycosylated hemoglobin, hypersensitive c-reactive protein andhomocysteine,folic acid such as biochemical indicators of patients with acute cerebralinfarction. Results:1.There was no statistically significant difference (P>0.05), gender, age,serum creatinine and transaminase compared between acute cerebral infarction groupand control group;differences were statistically significant (P<0.05),smoking history,history of hypertension and diabetes,levels of TG, LDL, HDL, internationalstandardization ratio, hypersensitive c-reactive protein, homocysteine, glycosylatedhemoglobin, and folic acid compared between AIC group and control group.2.Levels ofplasma ADMA were compared between groups.Levels of plasma ADMA in foursubgroups with ACI [(39.67±29.48);(56.73±25.41);(73.55±24.54);(90.51±23.66)umol/L,respectively] higher than control group(21.93±7.03umol/l),differences werestatistically significant(P<0.05).Multiple comparison between different area ofinfarction groups,lacunar infarction group compared with small, medium and largeinfarction group,differences were statistically significant(P=0.010,0.000,0.000).Smallinfarction group compared with medium and large infarction group, differences werestatistically significant(P=0.035,0.000).Infarction group compared with larger infarctiongroup, difference was statistically significant(P=0.028).The degree of nerve functiondefect grouping,levels of plasma ADMA in three subgroups with ACI[(48.69±33.27);(62.69±28.80);(83.58±21.27)umol/l,respectively] higher than control group(21.93±7.03umol/l),differences were statistically significant(P<0.001).Multiple comparisonbetween different degree of nerve injury groups,light infarction group compared withmidsize and severe infarction group, differences were statistically significant(P=0.017,0.000).Midsize infarction group compared with severe infarction group,difference was statistically significant(P=0.010).3.Correlation analysis:By theSpearman correlation analysis,we found that level of plasma ADMA showed anincreasing degree of infarction areas and neurological defect(r=0.633,r=0.392P<0.001).By the Pearson correlation analysis,we found that level of plasma ADMA showedpositively correlate with levels of creatinine, glycosylated hemoglobin, TG, LDL,hypersensitive c-reactive protein and homocysteine(P<0.001), and negatively correlatewith levels of folic acid and HDL(P<0.001).Through linear stepwise regression analysisfound that level of plasma ADMA showed a linear trend with levels of serum Hcy andhypersensitive c-reactive protein(B=2.505,8.124,P<0.001).Conclusion:1.Level of plasma ADMA in acute cerebral infarction group was higher than controlgroup. 2.Level of plasma ADMA showed an increasing trend with the increasing infarctionareas and degree of neurological defect,which prompted that level of plasma ADMAcan be used as one of the indicators, to judge the severity of acute brain infarction.3.Level of plasma ADMA showed positively correlate with levels of creatinine,glycosylated hemoglobin, TG, LDL, hypersensitive c-reactive protein and homocysteine,meanwhile negatively correlate with levels of folic acid and HDL.