Analysis The Relationship Of Level Of Serum Cystatin C And Lp (a) In Ischemic Stroke And Chinese Ischemic Stroke Subclassification

Objective : Levels of serum cystatin C and lipoprotein a [Lp(a)] in patients with acute ischemic stroke and patients with different subtype of Chinese ischemic stroke sub-classification(CISS)were observed. Analysize the relationship of level of seurm cystatin C and Lp(a) in acute ischemic stroke and different subtype of CISS respectively. As to provide theoretical basis for individualized prevention of ischemic stroke.Methods: All 200 patients with first-ever acute ischemic stroke in department of neurology,the second hospital of Lanzhou University were retrospectively recruited as observation group.136 patients without cerebrovascular disease at the same time in hospital were enrolled as control group.The observation group were distributed to different subgroups according to Chinese ischemic stroke sub-classification criteria based on the examination results. The level of serum cystatin C and Lp(a) of all 336 patients were measured in the morning of the second day after admission. Logistic multiple regression was used to analyze the relationship between ischemic stroke and the level of serum cystatin C, as well as among different subgroups of ischemic stroke and the level of serum cystatin C.Results:(1)Compared with the control group,the level of serum cystatin C and Lp(a) in ischemic stroke group and LAA, PAD subgroup were significant higher than those of control group(P﹤0.05). The serum cystatin C level in CS subgroup was higher than control group.(2) Compared with patients of LAA subgroup, the serum cystatin C and Lp(a) level was lower in patients of PAD subgroup(P﹤0.05);the level of Lp(a) in LAA subgroup is higher than that in CS subgroup,but it is no significant difference in level of serum cystatin C between the two group;CS subgroup has a higher serum cystatin C level than PAD subgroup, but it is no significant difference in level of Lp(a) between the two group.(3) Logistic regression analysis results showed that the high level of serum cystatin C and Lp(a) had significant correlation with ischemic stroke, the odds ratios of risk for ischemic stroke were 19.148(3.814~96.133) and 1.012(1.004~1.021),respectively.(4)Compared with the firstquintiles,the fifth quintiles is independently associated with acute ischemic stroke and LAA subgroup,the odds ratios of risk for ischemic stroke were(OR=4.461, 95%CI:1.599~12.443, P<0.05)and(OR=7.075, 95%CI:1.883 ~ 26.589, P=0.004), respectively.The high level of Lp(a) is also independently related to LAA subgroup,(OR=1.020, 95%CI:1.009~1.030, P<0.001).Conclusion:1.The high level of serum Cystatin C is an independent risk factor for ischemic stroke,and it has the more significance influence to LAA.2.The high level of Lp(a) is an independent risk factor for ischemic stroke,and it has the more significance influence to LAA. High levels of Lp(a) may be one of the risk remaining lipid-lowering therapy of large artery atherosclerotic stroke.3.It maybe have great significance to take reasonable interventions to the level of serum Cystatin C and Lp(a) in patients with LAA subtypes of ischemic stroke.