| Objective: Ischemic stroke(IS)is a major cause of death and disability in China.The research of exploring methods and drugs for brain protection in acute Ischemic stroke(AIS)is on the rise.Studies in vitro and animal experiments have shown that Angiopoietin-1(Ang-1)can promote the regeneration of neurons and angiogenesis,decrease the permeability of blood-brain barrier and inflammatory effects in the brain,and the elevated level of Ang-1 in AIS patients is an independent protective factor with good prognosis.However,the dynamic change of Ang-1 level in AIS patients and its effect on the recovery of neurological function and prognosis of patients have not been reported.The purpose of this study was to clarify the dynamic changes of Ang-1in AIS patients and its relationship with the severity and prognosis of AIS patients,so as to further explore the possibility of the application of Ang-1 in the intervention of prognosis in AIS patients.Methods: AIS patients who admitted to the Department of Neurology in the First Affiliated Hospital of Guangxi Medical University from August 2020 to November 2020 were included in this study.42 AIS patients were collected at the same time,and age and gender matched healthy control people(HC)were collected at the same time.Serum samples were collected on the day 3,the day 7and the day 14 of onset,respectively.And the National Institute of Health stroke scale(NIHSS)was used simultaneously to assess stroke severity,and the modified rankin scale(m RS)was used to assess prognosis at discharge and at day 90 of onset.Serum Ang-1 level was determined by ELISA.The correlation between Ang-1 level and stroke severity and prognosis was determined by Pearson or Spearman correlation method.Binary logistic regression analysis was used to select the optimal biomarker for predicting prognosis of AIS patients in90 days after AIS onset.Results: We found that Ang-1 level began to increase on the 3rd day after AIS and reached a peak on the 7th day after the onset of AIS.The level of Ang-1in the 3rd day and 7th day after the onset of AIS was significantly different from that in the HC group(p<0.05).The neutrophils count,neutrophilic lymphocyte ratio(NLR)and the level of hypersensitive C-reactive protein were negatively correlated on the 3rd day of onset,while the Ang-1 level was negatively correlated with NLR on the 7th day.The Ang-1 level was negatively correlated with NIHSS score on the 3rd day(r=-0.453,p<0.05)was negatively correlated with m RS score at discharge and 90 days after onset(r=-0.503,r=-0.599,p<0.05).Ang-1 level was negatively correlated with NIHSS score on day 7 and MRS score on day 90(r=-0.538,r=-0.636,p<0.05).Ang-1 level in the good prognosis group was significantly higher than that in the poor prognosis group on day 3 and day 7(p<0.05).Bary Logistic regression analysis showed that increased Ang-1 level on day 7 was an independent protective factor for the short-term prognosis of IS patients at 90 days.Conclusion: In AIS patients,the level of Ang-1 in peripheral blood increased firstly and then decreased dynamically.Moreover,increased Ang-1level on day 7 was an independent predictor of a good 90-day prognosis in IS patients.In addition,Ang-1 may play a protective role in the brain by down-regulating the expression level of inflammatory cytokines in peripheral blood. |
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