血浆ACSL4浓度及变化趋势与LAA型急性缺血性脑卒中的相关研究

Correlation between Trends in Plasma ACSL4 Levels and Prognosis of Acute Ischaemic Stroke of the Large Artery Atherosclerosis

摘要: 目的：动脉粥样硬化是常见的脑卒中危险因素之一，LAA型急性缺血性脑卒中患者的风险及临床结局预测对临床诊治至关重要。本研究旨在探讨血浆ACSL4浓度与LAA型急性缺血性脑卒中以及90天功能结局、安全结局和颈动脉粥样硬化斑块稳定性的关系，进一步为LAA型急性缺血性脑卒中的临床诊疗提供有价值的参考。方法：纳入146名确诊为LAA型脑梗死的患者和122名性别和年龄匹配的健康体检患者作为对照组。分析ACSL4血浆浓度及变化趋势与LAA型脑卒中患者的预后和颈动脉斑块稳定性的相关性。结果：对比健康人群，LAA型急性缺血性脑卒中患者血浆ACSL4水平升高(P < 0.05)，持续7天以上；在LAA型急性缺血型脑卒中患者中，脑卒中较严重的患者，血浆ACSL4水平较高，变化差异较明显；功能结局差的患者，血浆ACSL4水平较高(P < 0.05)，变化差异较明显；安全结局较差的患者，血浆ACSL4水平变化差异较明显(P < 0.05)；颈动脉斑块稳定性较差的患者，血浆ACSL4水平及变化差异均较明显(P < 0.05)。结论：LAA型急性缺血性脑卒中患者血浆ACSL4水平升高，与严重程度呈正相关，可作为LAA型急性缺血性脑卒中的独立危险因素。同时与较差的功能结局及颈动脉斑块稳定性呈正相关关系，血浆ACSL4变化水平较大导致较差的90 d安全结局及颈动脉斑块稳定性。

Abstract: Objective: Atherosclerosis is one of the common risk factors for stroke. The risk and clinical outcome prediction of patients with LAA-AIS are crucial for clinical diagnosis and treatment. This study aims to explore the relationship between plasma ACSL4 concentration and LAA-AIS, as well as 90-day functional outcomes, safety outcomes, and the stability of carotid atherosclerotic plaques, and further provide valuable references for the clinical diagnosis and treatment of LAA-AIS. Methods: 146 patients diagnosed with LAA-AIS and 122 healthy patients who underwent physical examinations and were matched by gender and age were included as the control group. To analyze the correlation between the plasma concentration and changing trend of ACSL4 and the prognosis and carotid plaque stability of patients with LAA-AIS. Results: Compared with the healthy population, the plasma ACSL4 level of patients with LAA-AIS increased (P < 0.05), lasting for more than 7 days; Among patients with LAA-AIS, those with more severe stroke have higher plasma ACSL4 levels, and the differences in changes are more obvious. Patients with poor functional outcomes had higher plasma ACSL4 levels (P < 0.05), and the difference in change was more obvious. Patients with poor safety outcomes had more significant differences in the changes of plasma ACSL4 levels (P < 0.05); Patients with poor stability of carotid artery plaques had more significant differences in plasma ACSL4 levels and changes (P < 0.05). Conclusion: The plasma ACSL4 level in patients with LAA-AIS is elevated and positively correlated with the severity, which can be regarded as an independent risk factor for LAA-AIS. At the same time, it was positively correlated with poor functional outcomes and carotid plaque stability. A large level of change in plasma ACSL4 led to poor 90-day safety outcomes and carotid plaque stability.