A Study On The Relationship Between Lipoprotein(a)level And Early Neurological Deterioration After Intravenous Thrombolysis In Acute Ischemic Stroke

Objective:To investigate the correlation between serum lipoprotein(a)[Lp(a)] level and early neurological deterioration(END)after intravenous thrombolysis of acute ischemic stroke(AIS),and to provide help for the prevention and early treatment of END after thrombolysis.Methods:A continuous collection of AIS patients within 4.5 hours of onset who were hospitalized in the Department of Neurology of the First Affiliated Hospital of Dali University from July 2017 to January 2021.All patients received intravenous thrombolytic therapy with alteplase(rt-PA).Serum Lp(a)levels were determined within24 hours of admission,and general data,related clinical data of the patients were collected.END was defined as the National Institutes of Health Stroke Scale(NIHSS)score increased by ≥ 4 points from baseline or death within 24 hours after intravenous rt-PA treatment.According to the changes in the NIHSS score of patients after thrombolysis,the patients were divided into non-END group and END group.Taking Lp(a)level as 30mg/d L as the critical point,Lp(a)is divided into low level(Lp(a)≤30mg/d L)and high level(Lp(a)>30mg/d L).The factors with significant differences in univariate analysis and the current clinically important factors are included in the multivariate binary Logistic regression model for analysis to explore the relationship between Lp(a)levels and END after intravenous thrombolysis.Results:A total of 116 AIS patients received rt-PA intravenous thrombolysis.6 cases were excluded due to incomplete data and bridging vein thrombus removal.In the end,110 patients were included in the study,of which 24 cases(21.8%)developed END,a low level There were 84 cases of Lp(a)and 26 cases of high-level Lp(a).Univariate analysis showed that compared with the non-END group,the Lp(a)level of the END group was lower(P<0.05);binary logistic regression analysis showed that even after controlling for potential confounding factors,the Lp(a)level of the END group is lower than that of the non-END group(OR = 0.066;95% CI: 0.006～0.697;P = 0.024).Low Lp(a)level may be a risk factor for END after thrombolysis.Conclusions:Lp(a)level is related to the occurrence of END after intravenous thrombolysis in AIS patients.For AIS patients with intravenous thrombolysis,low Lp(a)level may be a risk factor for END after thrombolysis.