Clinical Significance Of Low-Density Lipoprotein Subtypes In Ischemic Stroke Patients With Normal Blood Lipids

Objective:By detecting the level of low-density lipoprotein(LDL)subtypes in patients of acute cerebral infarction(ACI)of normal blood lipids,To investigate the influence of low-density lipoprotein subtypes on cerebral infarction of different TOAST types and the significance of the severity of cerebral infarction,which aimed to provide clinical diagnosis and treatment basis and opinions for cerebral infarction patients with normal blood lipids.Methods:This study used retrospective analysis to select 290 cases that met the criteria for the diagnosis and treatment of acute ischemic stroke in China in 2018 from September 2021 to September 2022.All patients had lipid profiles tested after admission,and the test results were normal.The main general clinical data of enrolled patients included gender,age,pressure value,smoking history,alcohol history,National Institutes of Health Stroke Scale(NIHSS)score at admission;Previous medical history included hypertension,hyperhomocysteinemia(Hhcy),and diabetes mellitus.Laboratory test results mainly include blood lipid detection,blood glucose and LDL accurate classification,etc.The auxiliary examinations mainly include cranial magnetic resonance imaging(MRI),cranial magnetic resonance angiography(MRA),digital subtract angiography(DSA),head CT and carotid ultrasound.According to the TOAST classification clinically common three types,the patients were segmented into three groups,124 cases in the Large artery atherosclerosis(LAA)group,21 cases in the Cardioembolism(CE)group,and 145 cases in the Small-artery occlusion(SAO)group.Because its Stroke of other determined cause(SOE)type and Stroke of undetermined cause(SUE)type are clinically rare,it is excluded.Statistical analysis was performed on the three groups.According to NIHSS score,LAA ACI patients were segmented into two groups,NIHSS score ≤3 was segmented into mild ACI group(72 cases),and NIHSS score >3 was segmented into non-mild ACI group(52 cases).The two subgroups were statistically analyzedResults:1.According to TOAST classification,the patients were divided into LAA group,CE group and SAO group.LDL1 and LDL3 were significantly different among the three groups(P<0.05).Multiple comparisons between groups showed significant differences in LDL1 and LDL3 between LAA group and SAO group and CE group(P<0.05),but there was no significant difference in LDL1 and LDL3 between CE group and SAO group(P>0.05).There was no significant difference in LDL2,LDL4,and LDL5～7 among the three groups(P>0.05).2.In LAA group,there were significant differences in LDL1,LDL3,LDL4,LDL5～7 between the NIHSS score ≤3 group and the NIHSS score >3group(P<0.05),but no significant difference in LDL2(P>0.05).LDL1 was negatively correlated with the severity of LAA cerebral infarction,and LDL3,LDL4,LDL5～7 were positively correlated with the severity of LAA cerebral infarction(P<0.05).Conclusions:1.In patients with cerebral infarction and normal blood lipid,LDL1,3subtypes are correlated with LAA.2.LDL1,LDL3,LDL4,and LDL5～7 subtypes were correlated with the severity of LAAACI in patients with normal blood lipids.