Correlation Between Peripheral Blood Inflammatory Levels And Neurological Deficits In Patients With Acute Cerebral Infarction In Different Age Groups

Objective: The inflammatory response has been shown to be a key factor in secondary brain injury following cerebral ischemia,and aging is an independent risk factor for ischemic stroke.As the age increases,the patient’s symptoms worsen,but age and cerebral ischemia occur.The relationship between inflammatory responses remains unclear.The aim of this study was to compare the differences in the degree of neurological deficits,the expression levels of peripheral blood inflammatory factors,and general risk factors in patients with different ages of acute ischemic stroke.In the inflammatory response level,the relationship between age and the expression of peripheral blood inflammatory factors and the degree of neurological deficits was investigated in patients with acute ischemic stroke.Methods: 180 patients with acute ischemic stroke who met the "2014 China Acute Ischemic Stroke Diagnosis and Treatment Guidelines" and whose TOAST classification was aortic atherosclerosis were collected.The neck vascular ultrasound and CT+CTA/MRI+MRA were collected.Blood routine,liver and kidney function,blood glucose,blood lipids,erythrocyte sedimentation rate,CRP and hemagglutination routine,etc.,the patients were divided into the elderly group(age ≥ 65 years old)and the young group(18 years old < age < 65 years old),and According to the cerebral infarction volume calculation formula proposed by Pullicino,the cerebral infarction volume of the selected patients was divided into three subgroups(large area,medium area,small area),and NIHSS scores were performed within 1 day,7 days and 14 days after admission.The venous blood levels were measured by enzyme-linked immunosorbent assay(ELISA),and the levels of serum inflammatory factors in patients with cerebral infarction of different ages were analyzed.Results: Among the young group,the old group calculated the cerebral infarction volume according to the formula of the cerebral infarction volume proposed by Pullicino [31],which was divided into A1(infarct volume < 5cm3),A2(infarct volume was 5-15cm3),A3(Infarct volume >15 cm3)and B1(infarct volume <5 cm3),B2(infarct volume 5-15 cm3),B3(infarct volume >15 cm3)three subgroups.1)Comparing the data of the A1 group and the B1 group,the A2 group and the B2 group,the A3 group and the B3 group in the history of smoking or drinking,the male-female ratio,the diabetes,the presence or absence of coronary heart disease,etc.There was no statistically significant difference in data and general risk factors(P > 0.05).2)Logistic regression analysis showed that the patient’s high NIHSS score and pro-inflammatory factor concentration were positively correlated with the old group(OR value >1,and B value>0),and the high anti-inflammatory factor concentration was negatively correlated with the old group(OR value < 1,and B value <0),there were statistical differences(P <0.05).3)One-way analysis of variance showed that the levels of neurological deficits,pro-inflammatory factors and anti-inflammatory factors in different age groups at different time points showed that the level of neurological deficits and pro-inflammatory factors decreased.The levels of anti-inflammatory factors showed an upward trend,and the differences were statistically significant(P < 0.05),and there were significant differences between the two groups at 1d,7d,and 14d(P < 0.05).4)Compare the NIHSS score,proinflammatory factor and anti-inflammatory factor concentration between A1 group and B1 group,A2 group and B2 group,A3 group and B3 group by paired t-test.The results suggest that the same infarct volume is the same infarction volume.Patients with higher NIHSS scores,higher concentrations of pro-inflammatory factors,and lower concentrations of anti-inflammatory factors(P < 0.05),the difference was statistically significant.Conclusion: 1.There are differences in the levels of inflammatory factors in acute ischemic stroke in different age groups.The higher concentrations of pro-inflammatory factors and lower anti-inflammatory factors in the elderly group suggest that the pro-inflammatory effect of older patients is stronger and stronger.The inflammatory effect is weaker,and the symptoms of the older group are more severe after the acute ischemic stroke,and the neurological deficit score is higher.2.The patient’s disease outcome can be reflected indirectly by the change of peripheral blood inflammatory factors after acute ischemic stroke,which provides a means for clinical judgment of the prognosis of ischemic cerebral infarction.