Dissertation
Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke) > Cerebral embolism

The Relationship of Serum Adiponectin、Nitric Oxide Synthase and Carotid Atherosclerosis in Patients with Acute Cerebral Infarction

Author ZhenXiaoZuo
Tutor CaoHong
School Dalian Medical University
Course Neurology
Keywords acute cerebral infarction carotid atherosclerosis adiponectin nitric oxide synthase
CLC R743.33
Type Master's thesis
Year 2011
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Objective: We measured the level changes of serum adiponectin (ADP)、constructive nitric oxide synthase(cNOS) and inducible nitric oxide synthase(iNOS) and observed the situation of carotid atherosclerosis(CAS) in acute cerebral infarction patients,researched the correlation between ADP、cNOS、iNOS and CAS,discussed the function and possible pathophysiological of ADP and NOS in ACI and atherosclerosis(AS).Methods: We selected 77 cases acute cerebral infarction patients as cerebral infarction group and 54 cases healthy people as control group,all of them meet the inclusion criteria and exclusion criteria with comparability in gender and age composition(P>0.05). We measured the level of ADP、cNOS、iNOS with methods of Enzyme-linked immunosorbent assay(ELISA) and chemical colorimetric and observed the level changes of ADP、cNOS、iNOS within 48 hours of onset and 10 days after admission. Detected carotid intima-media thickness(IMT) of two sides、inner diameter of carotid、peak velocity、atheromatous plaque of the two groups with carotid Doppler, and assessed the location、size、quality、echo characteristic of atheromatous plaque. For cerebral infarction patients neurologic deficits degree by the national institutes of health stroke scale (NIHSS) scores were evaluated in pathogenesis, within 48hours after admission and the first 10 days to assess twice. All data were analyzed by statistical software SPSS11.5, the two-sided test P <0.05 was test level of significance.Results:1、The level of serum ADP within 48 hours of onset in the patients of cerebral infarction group was significantly lower than in control group(P<0.05). 10 days after admission, The level of serum ADP was significantly higher than within 48 hours of onset(P<0.05) and there was no significant difference compared with control group.The level of serum cNOS within 48 hours of onset in the patients of cerebral infarction group was significantly lower than in control group(P<0.01) . After 10 days admission, The level of serum cNOS was significantly higher than within 48 hours of onset(P<0.05), but still significantly lower than control group(P<0.01).The level of serum iNOS within 48 hours of onset in the patients of cerebral infarction group was significantly higher than in control group(P<0.01). After 10 days admission, The level of serum iNOS was significantly lower than within 48 hours of onset(P<0.01), but without significantly difference compared with control group.2、Carotid artery IMT of two sides in the patients of cerebral infarction group was significantly higher than in control group(P<0.01), inner diameter of carotid artery of two sides had no significantly difference compared with control group, peak velocity of carotid artery of two sides was significantly lower than control group(P<0.01). CAS incidence rate and plaque detection rate in the patients of cerebral infarction group were significantly higher than the control group (P<0.01), constituent ratio of unstable plaque in cerebral infarction group is significantly higher than in control group (P<0.05), and the higher the plaque level, the more significance the difference was (P<0.01). The predilection site of plague in cerebral infarction group were the main stem of carotid artery、the crotch of carotid artery、the main stem of internal carotid artery and the beginning of internal carotid artery. The predilection site of plague in control group were the crotch of carotid artery、the main stem of carotid artery、the main stem of internal carotid artery and the beginning of internal carotid artery。There was no significantly difference between the two groups.3、The level of serum cNOS within 48 hours of onset in cerebral infarction group was independently negative correlative with the degree of nerve functions loss in the patients of cerebral infarction (P<0.05).4、The subtraction value of the level of serum ADP within 48 hours of onset and the level of serum ADP after 10 days admission、the level of serum cNOS and iNOS within 48 hours of onset in cerebral infarction group were all correlative with carotid artery IMT,the subtraction value of ADP had significantly positive correlation with carotid artery IMT (P<0.05), there was significantly negative correlation between cNOS、iNOS and carotid artery IMT(P<0.01, P<0.05).5、The level of serum ADP within 48 hours of onset in cerebral infarction group was not highly correlative with the level of cNOS and the level of iNOS after 10 days admission,but it was highly correlative with the level of iNOS within 48 hours of onset(P<0.05). The level of serum ADP after 10 days admission was not highly correlative with the level of cNOS and iNOS.Conclusion:1、The level of serum ADP in acute cerebral infarction group decreased significantly and had a obvious dynamic change. there was no significantly correlation between the level of serum ADP and the degree of nerve functions loss, The subtraction value of the levels of serum ADP within 48 hours of onset and after 10 days admission was correlative with the degree of CAS, which indicated ADP may be closely associated with the pathophysiology of CAS.2、there was a close relationship between CAS and the happen of acute cerebral infarction,and the relationship between unstable plague and cerebral infarction was closer than the relationship between stable plague and cerebral infarction.3、The level of serum cNOS decreased significantly and The level of serum iNOS increased markedly in the patients of acute cerebral infarction,and they all had obvious changes。iNOS may be closely associated with the pathophysiology of CAS. cNOS may be closely associated with acute cerebral infarction and the pathophysiology of CAS.4、There was significantly positive correlation between the levels of serum ADP and iNOS in the patients of acute cerebral infarction.

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