Correlation Of Serum ApoA1,Serum Uric Acid Level And Carotid Artery Plaque Type In Patients With Ischemic Cerebrovascular Disease

ABSTRACTObjective: In recent years,Ischemic cerebrovascular disease has become one of the most serious threats to human health in the world.its incidence of are on the rise and accounting for more than 80% of all stroke,The main cause of ischemic cerebrovascular disease is carotid atherosclerosis.Vascular stenosis or rupture of thrombosis which caused by Carotid plaque can lead to ICVD.Unstable carotid plaque has gradually become a hot topic which can evaluate the risk factors of cerebrovascular disease,In the current,domestic and foreign both uniform with unstable plaque or unstable plaque to define those with shedding,rupture,bleeding tendency,prone to thrombosis risk spots Piece.Early identification of carotid plaque type and taking active intervention has important significance which can reduce the incidence of stroke.Apolipoprotein A1 is responsible for running the function of cholesterol in plasma,the high level HDL can romote the body's peripheral tissues(including arterial wall)to remove cholesterol,anti atherogenic effect of HDL may be realized by apolipoprotein A1;At the same time,the occurrence and development of lipid deposition also have important contact with the blood uric acid,therefore to explore serum Apo A1 and serum uric acid levels in the evaluation of atherosclerotic disease has great clinical significance.At present,there are many researches about the risk factors and intracranial angiography the ICVD patients.but there are few reports about the correlation among carotid plaque type and serum apolipoprotein A1 and serum uric acid levels.The purpose of this study was to investigate the relationship between carotid atherosclerotic plaques and carotid atherosclerotic plaques by color Doppler ultrasonography,and to analyze the nature,location,size and quantity of carotid atherosclerotic plaques.Combined with serum Apo A1 and serum uric acid levels,which can provide reference and guidance for the prevention of ischemic cerebrovascular disease.Method:1 grouping of research objectsBased on the diagnostic criteria of the Fourth Academic Session of the National Cerebrovascular Disease Conference in 1995,To carotid artery color Doppler ultrasonography in 856 cases of patients which have clinical symptoms of acute ischemic brain disease that were treated in Department of Neurology,Hengshui Fifth People 's Hospital from October 2014 to December 2015,then according to whether the plaque,and plaque type of ultrasonic diagnostic criteria,divided into three groups as the object of study,including unstable plaque group 60 cases,stable plaques 60 cases of block group,60 cases of plaque group.There were no statistically significant differences in age,sex,and blood pressure among the selected groups(> 0.05).2 The screening of carotid plaqueThe bilateral common carotid artery,external carotid artery and internal carotid artery were examined in order according to the order of Philips IU22(frequency 7.5-10MHz)color Doppler ultrasonography.The contents included blood vessel lumen diameter,blood flow velocity,blood vessel Intima smoothness and the thickness of the middle,with or without plaque formation,the size of plaques,echo and so on.Diagnostic criteria for plaque formation were carotid intima-media thickness IMT <1.0 mm normal,IMT 1.0-1.2 mm thickened,and IMT> 1.2 mm diagnosed carotid plaque formation.3 The collection of blood samples,the detection of serum ApoA1 and serum uric acid detectionApplication of Japan's Beckman DxC600 i automatic biochemical analyzer also supporting the corresponding test kit,all patients enrolled in the next day after admission,morning fasting venous blood extraction 4ml,30 minutes to send the test section centrifugation,centrifugation specimens within 2 hours Serum ApoA1,serum uric acid detection.4 Statistical MethodsThe data were processed and analyzed by SPSS 17.0 statistical software package,in which the count data were compared by 2 test,the measurement data were expressed as standard deviation of mean ± standard deviation(± S).The comparison of the mean between groups was analyzed by t test,<0.05 indicates that the difference was statistically significant.Results:1 The detection results of carotid plaqueIn the 60 unstable plaque group,134 plaques were found in the common carotid artery and bifurcation(58.9%),the internal carotid artery 46(34.3%),the external carotid artery 9(6.7%).Five of the patients had four plaques in the carotid artery,three in the 16 patients,two in the 27 patients,and one in the 12 patients.(60.5%),internal carotid artery 29(36.87%),external carotid artery 2(2.63%),plaque located in the common carotid artery and bifurcation of 45(60.5%),60 cases of stable plaque group,;1 patient had 3 plaques,14 patients had 2 plaques,and 45 patients had 1 plaque.The number of carotid plaques detected between the two groups was statistically significant(<0.05).2 Levels of serum ApoA1 and serum uric acidThe level of serum ApoA1 in unstable plaque group was lower than that in stable plaque group(P <0.05).The serum ApoA1 level in unstable plaque group was lower than that in plaque group(< 0.01).The serum ApoA1 level in stable plaque group was lower than that in non-plaque group(P <0.05).The level of serum uric acid in the unstable plaque group was significantly higher than that in the plaque group(P <0.05).The level of serum uric acid in the unstable plaque group was significantly higher than that in the plaque group(P <0.05).The level of serum uric acid in stable plaque group was higher than that in plaque-free group(P <0.05).Conclusion:1 The decrease of serum ApoA1 is closely related to the instability of carotid plaque in patients with ischemic cerebrovascular disease,ApoA1 reduction may be a factor to promote the formation of unstable carotid plaques.2 The increase of serum uric acid level is closely related to the formation of carotid plaque in patients with ischemic cerebrovascular disease and the instability of the plaque.3 The carotid plaque type which have clinical symptoms of ischemic cerebrovascular disease,mainly to unstable plaques.4 Ischemic cerebrovascular disease in patients with carotid plaques occur in the common carotid artery bifurcation and internal carotid artery at the beginning.