Abstract:

Objective

To investigate the relationship between plasma monocyte chemoattractant protein-1 （MCP-1）， chitinase protein-40 （YKL-40） and poor cerebral collateral circulation in patients with acute ischemic stroke （AIS） with severe stenosis or occlusion of unilateral symptomatic middle cerebral artery （MCA）-M1 segment.

Methods

A total of 150 AIS patients with unilateral symptomatic severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment admitted to Brain Disease Department of Enshi Tujia and Miao Autonomous Prefecture Central Hospital from June 2020 to June 2023 were selected. According to the formation of cerebral collateral circulation， they were divided into good group and poor group. The levels of plasma MCP-1 and YKL-40 were detected and compared between the two groups. The risk factors of poor cerebral collateral circulation were analyzed by multivariate Logistic regression model. The receiver operating characteristic （ROC） curve was used to analyze the predictive value of plasma MCP-1 and YKL-40 for poor collateral circulation in patients.

Results

Among 150 AIS patients with unilateral symptomatic severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment， 63 patients had poor collateral circulation （poor group）， and the remaining 87 patients were included in the good group. The levels of plasma MCP-1 and YKL-40 in the poor group were higher than those in the good group， and the differences were statistically significant （P＜0.05）. High levels of TC （≥4.5 mmol/L）， Hcy （≥20 mmol/L）， MCP-1 （≥160 μg/L） and YKL-40 （≥150 pg/mL） were independent risk factors for poor cerebral collateral circulation in AIS patients with severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment （P＜0.05）. The area under curve （AUC） of plasma MCP-1， YKL-40 alone and combined prediction of poor cerebral collateral circulation in patients was 0.875， 0.869 and 0.947，respectively， and the combined prediction effect was the best.

Conclusions

The levels of plasma MCP-1 and YKL-40 are increased in AIS patients with severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment， and the increased levels of MCP-1 and YKL-40 are independent risk factors for poor cerebral collateral circulation. The combined detection has a higher predictive value for poor cerebral collateral circulation in AIS patients with severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment.

Key words: Symptomatic middle cerebral artery stenosis, Acute ischemic stroke, Cerebral collateral circulation, Monocyte chemoattractant protein-1, Chitinase protein-40