Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2012
Student: DİLEK YILMAZ
Supervisor: EMİNE BELGİN KOÇER
Abstract:Acute cerebral ischemia is caused by different pathophysiological mechanisms. P-selectin and TAFI expression has been shown to be elevated in iscemic stroke and as a risc factor for aterosclerosis and tromboembolism. We investigate P-selectin and TAFI levels which shown to be effect through different pathophysiological mechanisms in stroke and examine their relation between common carotid artery intima-media thickness (IMT), internal carotid artery stenosis and clinical parameters. We included 40 subject with acute ischemic stroke and 22 control subjects without stroke. Venous blood was obtained on admission (within 48 h), in the 7.days, 14.days and 1.month after the stroke onset. The intima-media thickness of the common carotid artery and internal carotid artery stenosis was measured by using B-mode ultrasound in all subjects. P-selectin levels in the patient and control groups showed no significant differences betweeen all time periods (p>0.05). TAFI activity level was significantly higher in patient group than control grups within 48h (%128.2±21.0 / 111.6±17.4), in the 7.day (%128.5±24.2 / 110.5±19.2), 14.day (%129.7±18.8 / 106.3±16.8) and 1.month (%132.9±22.0 / 111.4±18.5) (p<0.001, p<0.004). The serum TAFI levels in the 14th days and the 1.month were higher (p=0.047, p=0.033) at large vessel atherosclerosis than lacuner infarct. Serum P-selectin levels according to the etiological classification wasn?nt different among the groups. It wasn?nt found a significant relationship in between serum P-selectin, 74 TAFI levels and scales of NIHSS, Barthell and RANKIN (p<0.05). However, the NIHSS and RANKIN decreased over time, but the index of Barthell increased, this is interpreted as a clinical improvement. As a result, we wasn?t found positive correlation between elevated serum P- selectin levels and common carotid artery IMT in acute and subacute iscemic stroke but we found positive correlation between increased TAFI levels and carotid artery IMT and stenosis rates. We concluded that increased TAFI levels was thought to be an early marker of atherosclerosis in iscemic stroke and asymptomatic atherosclerosis.