Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 ...Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.展开更多
目的探讨弱氧化性低密度脂蛋白(minimally modified low density lipoprotein,mmLDL)上调在体小鼠肠系膜动脉ETA受体的作用(endothelin type A receptors,ETA)并考察自噬是否参与这一过程。方法小鼠尾静脉注射mmLDL,腹腔注射ClassⅢPI3...目的探讨弱氧化性低密度脂蛋白(minimally modified low density lipoprotein,mmLDL)上调在体小鼠肠系膜动脉ETA受体的作用(endothelin type A receptors,ETA)并考察自噬是否参与这一过程。方法小鼠尾静脉注射mmLDL,腹腔注射ClassⅢPI3K自噬通路抑制剂6-氨基-3-甲基嘌呤(3-methyladenine,3-MA),探究自噬在mmLDL给药处理小鼠中的作用,微血管张力描记仪观察内皮素-1(endothelin-1,ET-1)引起的小鼠肠系膜动脉收缩量效曲线的变化,RT-PCR定量ETA受体mRNA,Western blot检测ETA受体和ClassⅢPI3K、Beclin-1、LC3-Ⅱ/Ⅰ、p62及p-NF-κB、NF-κB的蛋白水平表达。结果mmLDL引起ET-1收缩量效曲线明显增强,表现为Emax值由生理盐水(NS)组的(184.87±7.46)%上升为(319.91±20.31)%(P<0.001),pEC50值由NS组的(8.05±0.05)上升为(9.11±0.09)(P<0.01)。mmLDL在上调ClassⅢPI3K、beclin-1、LC3-Ⅱ/Ⅰ和下调p62蛋白水平的同时,也引起ETA受体mRNA水平、蛋白表达明显增加,增加了p-NF-κB的蛋白水平;腹腔注射3-MA抑制了mmLDL的这些作用。结论mmLDL能通过ClassⅢPI3K/Beclin-1通路激活自噬及下游NF-κB通路上调ETA受体。展开更多
文摘Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.
文摘目的探讨弱氧化性低密度脂蛋白(minimally modified low density lipoprotein,mmLDL)上调在体小鼠肠系膜动脉ETA受体的作用(endothelin type A receptors,ETA)并考察自噬是否参与这一过程。方法小鼠尾静脉注射mmLDL,腹腔注射ClassⅢPI3K自噬通路抑制剂6-氨基-3-甲基嘌呤(3-methyladenine,3-MA),探究自噬在mmLDL给药处理小鼠中的作用,微血管张力描记仪观察内皮素-1(endothelin-1,ET-1)引起的小鼠肠系膜动脉收缩量效曲线的变化,RT-PCR定量ETA受体mRNA,Western blot检测ETA受体和ClassⅢPI3K、Beclin-1、LC3-Ⅱ/Ⅰ、p62及p-NF-κB、NF-κB的蛋白水平表达。结果mmLDL引起ET-1收缩量效曲线明显增强,表现为Emax值由生理盐水(NS)组的(184.87±7.46)%上升为(319.91±20.31)%(P<0.001),pEC50值由NS组的(8.05±0.05)上升为(9.11±0.09)(P<0.01)。mmLDL在上调ClassⅢPI3K、beclin-1、LC3-Ⅱ/Ⅰ和下调p62蛋白水平的同时,也引起ETA受体mRNA水平、蛋白表达明显增加,增加了p-NF-κB的蛋白水平;腹腔注射3-MA抑制了mmLDL的这些作用。结论mmLDL能通过ClassⅢPI3K/Beclin-1通路激活自噬及下游NF-κB通路上调ETA受体。
基金国家自然科学基金资助项目(81202535)%湖南省科技厅自然科学基金资助项目(2018JJ6097)%湖南省卫生计生委资助课题(B2017183)%郴州市科技局资助项目(jsyf2017025)China National Natural Science Foundation(81202535)%Natural Science Fund Project of Hunan Science and Technology Department(2018JJ6097)%Hunan Provincial Health and Family Planning Commission Fund Project(B2017183)%Chenzhou Science and Technology Bureau Fund Project(jsyf2017025)
