Correlation Between Changes Of Plasma Brain-derived Neurotrophic Factor And Brain-gut Peptide Levels In Acute Phase Of Ischemic Stroke And TCM Syndromes

Stroke is a common clinical disease in neurology.It has high morbidity,high disability rate,high recurrence rate,high death rate,etc.Its onset is acute and the condition changes.The treatment and rehabilitation in the acute phase largely affect the outcome,prognosis and later life ability.Syndrome is a feature of traditional Chinese medicine.Today,scholars focus more on exploring the correlation between syndromes and laboratory indicators,and try to supplement and perfect the micro-foundation of the acute phase of stroke.Brain-gut peptide is a peptide substance distributed in the central nervous system and the gastrointestinal tract.Recent studies have confirmed that the levels of some brain-gut peptides have a certain correlation with the development of the acute stroke syndrome,but the results are not the same.As one of the most important neurotrophic factor,brain-derived neurotrophic factor(BDNF),has received extensive attention for its neuroprotective effect.Related studies suggest that changes in BDNF levels are associated with post-stroke ischemic and hypoxic injury and neurological deficits.However,there are few studies on the changes of BDNF levels in different TCM syndromes during the acute phase of stroke,and this study focused on it,trying to explore the correlation between the level changes of the above indicators in the acute phase and TCM syndromes.Objective:To explore the levels of plasma brain-derived neurotrophic factor and partial brain-gut peptides(motilin,gastrin,and cholecystokinin)in the acute phase of ischemic stroke patients and their correlation with TCM syndromes,and the correlation between each indicator and the degree of neurological deficit.Method:Patients with acute ischemic stroke who were hospitalized from June 2016 to December 2017 in Dongfang Hospital were selected as subjects.According to the criteria for diagnosis of stroke syndromes,they were divided into seven groups.Then plasma brain-derived neurotrophic factor,motilin,gastrin,and cholecystokinin levels were measured on the first day after the onset,the 7th day of the disease and the 14th day of the disease,using enzyme-linked immunosorbent assay.At the same time,we performed the National Institutes of Health Stroke Scale(NIHSS)to assess the levels of neurological deficits and also collected some relevant data.Finally we used SPSS20 software for statistical analysis.Results:(1)Plasma MTL levels in patients with acute ischemic stroke on the first day after admission,the seventh day of the disease and the fourteenth day of the disease were significantly higher than those in the control group(p<0.01).The levels became the highest on the seventh day and then slowly dropped.(p<0.01).The plasma GAS levels measured at the three moments were higher than those of the control group,with significant differences(p<0.01).There was a declining trend.The plasma CCK levels at the three time points were significantly higher than those in the control group(p<0.01).The overall course in the first 14 days showed a trend of first increase and then decrease,peaking at the 7th day.The plasma BDNF of the days,the 7th day and the 14th day of the disease was lower than those in the control group,and there was a significant difference(p<0.01).(2)In the acute phase of ischemic stroke,there were larger numbers of patients of accumulated wind-phlegm-blood stasis syndrome group,excess of wind-phlegm-fire syndrome group and phlegm-heat and fu-excess syndrome group.Plasma MTL,CCK were highest in phlegm-heat and fu-excess syndrome group.Group of phlegm-damp clouding orifices syndrome had the highest level of plasma GAS and the lowest level of plasma BDNF.Unfortunatly they were not statistically significant(p>0.05).(3)In the acute ischemic stroke phase,the NIHSS score was highest among the phlegm-damp clouding orifices syndrome,followed by the group of wind formation from yin deficiency.However they were not statistically significant(p>0.05).There were no correlation between the degree of neurological deficit and the levels of plasma indicators which were MTL,GAS,CCK and BDNF(p>0.05).Conclusion:Plasma BDNF and brain-gut peptide levels are present in the acute phase of ischemic stroke and show a certain trend of change.BDNF and brain-gut peptide levels vary among TCM syndrome types,especially in the case of phlegm-heat and fu-excess syndrome and phlegm-damp clouding orifices syndrome.All indexes are involved in the process of ischemic stroke and the formation process of TCM syndromes.Measuring the level of these four indexs in the acute phase of stroke may have clinical significance in disease diagnosis,prognosis of the disease,and so on.