Application Of NETs In The Diagnosis Of Acute Ischemic Stroke

Objective(s):In this study,we explored the correlation between thrombus neutrophil extracellular trapping nets(NETs)and serum NETs in patients with acute ischemic stroke,and the diagnostic value of serum NETs in acute ischemic stroke in order to provide specific circulating markers and new diagnostic ideas for acute ischemic stroke.Methods:In this study,55 patients with acute ischemic stroke were selected as the experimental group,including 15 patients with acute ischemic stroke who underwent endovascular interventional thrombectomy and 40 patients with acute ischemic stroke who underwent conservative medical treatment,and 40 patients with non-acute ischemic stroke who matched for gender and age in the outpatient clinic and physical examination center of our hospital during the same period were selected as the control group.Patients’ baseline clinical data and laboratory test results were collected through an electronic medical record system.HE staining and immunofluorescence staining were used to observe the expression of NETs in thrombi of patients with acute ischemic stroke,and enzyme-linked immunosorbent assay was used to detect the serum Cit H3/NETs concentration levels in all study subjects.IBM SPSS Statistic21.0 software was used for statistical analysis to analyze the correlation between thrombotic NETs and serum NETs in the intravascular interventional thrombectomy group for acute ischemic stroke,compare the differences in serum Cit H3/NETs concentration levels between the acute ischemic stroke group and the non-acute ischemic stroke group,and evaluate the value of serum NETs in the diagnosis of acute ischemic stroke.Results:1.The history of hypertension,atrial fibrillation,NEUT,FDP and D-D levels in patients with acute ischemic stroke were significantly higher than those in the control group(P < 0.05);2.Immunofluorescence staining showed that Cit H3/NETs were expressed in arterial thrombi of 15 patients with acute ischemic stroke.Cit H3/NETs was positively correlated with Cit H3/NETs and NIHSS scores in patients with acute ischemic stroke,and the correlation coefficients were 0.546 and 0.703,respectively(P < 0.05);3.Serum Cit H3/NETs in patients with acute ischemic stroke were significantly higher than those in patients without acute ischemic stroke,P < 0.05,which were statistically significant.Serum Cit H3/NETs were positively correlated with atrial fibrillation and NIHSS scores,and the correlation coefficients were 0.376 and 0.441,respectively(P < 0.05),which were statistically significant,but not significantly correlated with other outcome measures;4.Binary logistic regression was used to analyze the risk factors of acute ischemic stroke,and the results suggested that the odds ratios of hypertension,serum Cit H3/NETs,and FIB were 18.857,7.212,and 2.462,respectively,P < 0.05,which were statistically significant;5.ROC curve was used to evaluate the value of serum Cit H3/NETs in the diagnosis of acute ischemic stroke,and the results suggested that the area under ROC curve of serum Cit H3/NETs combined with NEUT,serum Cit H3/NETs,and serum NEUT was 0.893,0.843,and 0.811,respectively,P < 0.05,which was statistically significant.Serum Cit H3/NETs has a good diagnostic value for acute ischemic stroke,but the diagnostic effect of Cit H3/NETs combined with NEUT is better than that of Cit H3/NETs alone in the diagnosis of acute ischemic stroke.Conclusion(s):1.Cit H3/NETs were expressed in arterial thrombus of patients with acute ischemic stroke,and there was a positive correlation between Cit H3/NETs and serum Cit H3/NETs.2.Serum Cit H3/NETs can provide the basis for the diagnosis and treatment of thrombotic diseases;3.Serum Cit H3/NETs are expected to be circulating markers for the initial diagnosis of acute ischemic stroke.