| Objective:Infarction because of its high incidence and high mortality,high morbidity has become one of the major killers of mankind, and the heavyfinancial burden and pressure on social and family life. Cerebral infarction hasvarious risk factors, including age, smoking, gender, obesity, hypertension,diabetes, hyperlipidemia and atherosclerosis, etc. Reasonable control of riskfactors for cerebral infarction in time is the primary prevention of stroke.Atherosclerosis is the pathological basis of cerebral infarction, and oxidizedlow density lipoprotein (ox-LDL) plays a key role in the process of theoccurrence and development of atherosclerosis. Through the analysis ofrelevant risk factors and serum ox-LDL levels in110patients with acutecerebral infarction, this article provides a basis for the evaluation of thedegrees and prognosis, prediction of risk factors and treatment.Methods:From February,2013to November,2013, a total of110patients (58men and52women; mean age60.64±10.73years) with initialacute cerebral infarction within72hours that treated in No.2Affiliatedhospital of Hebei medical university were evaluated in our study as case group.Diagnosed by craniocerebral CT and MRI, all patients’ diagnosis were up tothe diagnostic criteria revised by the fourth national cerebrovascular diseaseconference, and according to the TOAST classification, excluding ofcardioembolism （CE）,stroke of other determined etiology （SOE） andstroke of other undetermined etiology （SUE）.There are57cases with large-artery atherosclerosis（LAA）while53with small-artery occlusion lacunar（SAO）. We divided the patients into mild (＜7points,41cases), moderate(7to15points,39cases) and severe (＞15points,30cases) according toNIHSS grade. Another30healthy population (16men and14women; mean age59.86±11.85years) chosen from Physical Examination Department inNo.2Affiliated hospital of Hebei medical university were as the control group.Routine examination of blood, urine and stool, blood coagulation andblood biochemistry were checked in all cases of two groups. Exclusion criteriaincluded: a history of stroke, atrial fibrillation, unstable angina pectoris andimmune system diseases; myocardial infarction within half year; lowerextremity vascular disease; malignancy; severe hepatic and renal dysfunction;severe sepsis; oral antioxidant, statins and hormone or immunosuppressor. Allcases were drawn early morning fasting venous blood2ml, serum specimensafter centrifugation and stored at-80℃in the refrigerator.The examination ofox-LDL was done by enzyme linked immunosorbent assay (ELISA). Medicalhistory and the risk factors of stroke were collected by questionnaires. Acarotid ultrasound was used in all cases of the case group and divided thepatients into groups of cerebral infarction without plaque (39cases), stableplaque (32cases) and unstable plaque (39cases).Statistical analysis was done by SPSS13.0software to compare thedifferences of each value between groups and analyze correlation of relativefactors of groups. All data were measured by mean±standard deviation (χ±s). The2-test was used for enumeration data, and the study t-test formeasurement data. Comparison between groups was done by analysis ofvariance. A value of P<0.05was used to determine statistical significance.Results:1In the comparison of risk factors of acute cerebral infarction in twogroups, there had a statistically significant difference (P＜0.05) in smoking,hypertension, diabetes and low density lipoprotein (LDL), while no strongcorrelation existed in the age, gender, drinking, family history, coronary heartdisease, total cholesterol, triglyceride, homocysteine and BMI.2We found the serum ox-LDL level in case group is higher than incontrol group and the difference was statistically significant(P＜0.01).Theserum ox-LDL levels in both LAA group and SAO group are higher than incontrol group.And the serum ox-LDL level in LAA group is higher than in SAO group.When comparison in no matter case groups and sub-group (LAAgroup and SAO group) with control group, the difference was statisticallysignificant(P＜0.01). Multiple comparisons shows that there was statisticallysignificant when compared among groups.3In the group divided by the NIHSS grade, we found a statisticallysignificant difference in comparison between any two groups (P＜0.01)except the moderate group with severe group(P＞0.05). And as the rank ofthe NIHSS grade increases, the level of serum ox-LDL raises.Multiplecomparisons in different plaque groups also showed statistically significantdifferences (P＜0.05).4According to the result of carotid ultrasound, the ox-LDL level in stableand unstable plaque group is higher than no plaque group, and different plaquegroups had statistically significant differences when compared to no plaquegroup (P＜0.01). Multiple comparisons in different plaque groups alsoshowed statistically significant differences（P＜0.05）.Conclusion:Smoking, hypertension, diabetes, low density cholesterol is associatedwith the occurrence of acute cerebral infarction. The ox-LDL level is muchhigher in case group than control group, as well as LAA group vs. SAO group.In NIHSS grade, differences were found in the level of serum ox-LDL incomparisons of each group. With the rise of NIHSS score,serum ox-LDL levelalso will increase.So we can infer that, the oxidative stress which ox-LDLinvolved in was associated with the occurrence and development of acutecerebral infarction, and is mainly to promote the formation of LAA. Thedifferent ox-LDL levels in each plaque group shows that, ox-LDL participatein the formation of the plaques, and are closely related to the stability of theplaques. Ox-LDL can reflecting the degree of nerve function defect andacting as a serum marker of acute cerebral infarction, suggesting the existence of the unstable plaques and evaluating the condition and prognosis of acutecerebral infarction. |
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