| Objective: Stroke is the second cause of death and disability worldwide,whereas is a leading cause of mortality in our country,which has a serious impact on human health.Ischemic stroke accounts for 87% in all patients with stroke.Vascular cognitive impairment following stroke is the main sequela that is common.To investigate the effect of human urinary kallidinogenase(HUK)on expression of VEGF,ANG and apelin in the serum with acute cerebral infarction(ACI),we designed this experiment.Further,we want to explore the relationship between the role of HUK on angiogenesis and cognitive impairment.Methods:1 One hundred ACI patients in The Second Hospital of Hebei Medical University were enrolled in this study,which were randomly divided into HUK group and conventional group.2 The NHISS score and cognitive function score were assessed at first day,14 th day and 3rd month.We collected 5ml fasting venous blood,and the concentration of VEGF,ANG,apelin in serum were tested by ELISA.Results:1 Distribution:100 patients with ACI were included in the study,all the enrolled patients met the criteria.However,22 patients were removed from the experimental process because of the aggravation of the disease and the patients with less cooperation.Finally,45 received HUK,while the other 33 were selected as control.2 The comparison of baseline data: there was no difference in demographic characteristics: such as age,gender,education level and so on(P>0.05).Neurological deficits and cognitive function were similar in the two groups at admission(P>0.05).3 Evaluation of clinical efficacy: the NIHSS score had no difference at admission,however the score had a decline at 14 th day and 3rd month.But there was no significant difference before and after treatment(P>0.05).The efficacy in the kallikrein group was greater than the conventional group(P<0.05).4 Cognitive function evaluation: There was no difference in cognitive function scores between the two groups at admission.The cognitive function of kallikrein group decreased compared with conventional group,there was statistical difference between two groups at 14 th day(P<0.05),whereas there was no at 3rd month(P>0.05).With the extension of time,the scores of Boston naming tests showed a trend of decline in kallikrein group,but there was a continuous increased in conventional group.There was no significant difference before and after treatment(P>0.05).The scores of Boston naming tests in different groups were statistically significant at 14 th day(P<0.05),whereas there was no at 3th month(P>0.05).In the Auditory verbal learning test,there was a statistically significant difference between the 14 th day and 3rd month after treatment in kallikrein group(P<0.05).There was significant difference with immediate memory and long-term memory at 14 th day between the two groups(P<0.05),there was no defference with Short-term memory(P>0.05).There were no at 3rd month(P>0.05).5 The concentration of VEGF: There was no difference in serum VEGF level between the two groups at admission.With the extension of time,the concentration of VEGF in kallikrein group showed a trend of first increased and then decreased,but there was a continuous decline in conventional group.There was no significant difference before and after treatment(P>0.05).The difference was statistically significant at 14 th day between the two groups(P<0.05),whereas there was no at 3rd month(P>0.05).6 The concentration of ANG: There was no difference in serum ANG level between the two groups at admission.With the extension of time,the concentration of ANG in kallikrein group showed a trend of first decreased and then increased,but there was a continuous decline in conventional group.But there was no significant difference before and after treatment(P>0.05).Whereas the difference was statistically significant at 14 th day and 3rd monthbetween the two groups(P<0.05).7 The concentration of apelin: There was no difference in serum apelin level between the two groups at admission.With the extension of time,the concentration of apelin in kallikrein group showed a trend of first increased and then decreased,there was a statistically significant difference between the 3rd month after treatment and before treatment(P<0.05).There was a similar trend in the conventional group,but there was no defference(P>0.05).Whereas the difference was statistically significant at 14 th day and 3rd month between the two groups(P<0.05).Conclusions:1 HUK had a significant improvement in neurological function in patients with ACI,and there was a significant improvement in 3rd month.2 HUK can reduce the cognitive impairment in patients with ACI,improve the patient's memory,language function.2 HUK facilitated post-ischemic angiogenesis strongly by increasing the concentration of VEGF,ANG,apelin,which is one of the important mechanisms to improve cognition and prognosis. |
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