Abstract: Abstract：Objective To investigate the relationship between the serum levels of tenascin-C (TN-C) and irisin and the severity and prognosis in patients with H-type hypertension complicated with acute ischemic stroke. Methods A total of 126 patients with H-type hypertension complicated with acute ischemic stroke hospitalized in our hospital from June 2017 to September 2018 were selected as case group, and 63 patients with H-type hypertension without acute ischemic stroke were selected as control group. According to NIHSS score at the time of admission, the case group was divided into mild group (n=38), moderate group (n=57) and severe group (n=31). According to mRS score 90 days after treatment, the case group was divided into good prognosis group (n=77) and poor prognosis group (n=49). Serum levels of TN-C and irisin were measured by ELISA method. The relationship between serum levels of TNC and irisin and the severity and prognosis of Htype hypertension complicated with acute ischemic stroke was analyzed. The clinical values of TN-C and irisin in the prognosis of patients with H-type hypertension complicated with acute ischemic stroke were analyzed by receiver operating curve (ROC). Results The serum level of TN-C was significantly higher in case group than that in control group (P＜0.05),while the serum level of irisin was significantly lower than that in control group (P＜0.05). The serum TN-C level increased with the severity of the disease, while the serum irisin level decreased with the severity of the disease (P＜0.05). The serum level of TN-C was lower in patients with good prognosis than that in patients with poor prognosis (P＜0.05) while the serum level of irisin was higher in patients with good prognosis than that in patients with poor prognosis (P＜0.05). The serum TNC level was positively correlated with NIHSS score and mRS score (r=0.579, 0.603, P＜0.05), while the serum irisin level was negatively correlated with NIHSS score and mRS score (rs=-0.526, -0.497, P＜0.05). The area under the curve of TN-C and irisin for predicting the prognosis of patients with H-type hypertension complicated with acute ischemic stroke were 0.832 and 0.784 respectively. When the cut-off values were 81.68 μg/L and 92.39 μg/L, the sensitivities were 69.4% and 63.6% respectively, and the specificities were 85.7% and 89.8% respectively. Conclusion The serum TN-C and irisin are involved in the pathogenesis of H-type hypertension complicated with acute ischemic stroke, and related to the severity and prognosis of the disease. They could be used as biomarkers for early evaluation of the severity and prognosis of the disease.

Key words: hypertension, cerebral ischemia, stroke, tenascin-C, irisin, severity, prognosis