Discussion On The Relationship Between Non-high-density Lipoprotein Cholesterol And Neurological Impairment In Patients With Ischemic Stroke

Objective The purpose of this study was to explore the relationship between serum non-high-density lipoprotein cholesterol(non-HDL-C)and neurologic impairment in patients with acute ischemic stroke and its clinical value in disease risk assessment.To provide a new effective measurement indicators and control targets for the ischemic stroke patients with neurological impairment risk assessment.Methods In the third ward of department of Neurology of Tianjin Huanhu Hospital,we continuously elected 611 patients who were suffering from acute ischemic stroke from October 2010-October 2014.All of them underwent head CT?head MRI to reveal the presence of acute ischemic stroke in this study.The above patients according to serum non-HDL-C concentration was divided into the ideal level group and high level group,which were further divided into the ideal level,the critical high level and significantly increased level.NIHSS,CSS,ESS and BI were used to evaluate the degree of neurologic impairments.Total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),and fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),homocysteine(Hcy),hypersensitive c-reactive protein(hs-CRP)were measured in all the patients.Then non-HDL-C were calculated with the formula of TC minus HDL-C.We used SPSS 23.0 statistical software for data calculation and analysis.NIHSS,CSS,ESS,and BI scores were compared in patients of the ideal level group and high level group to evaluate the relationship between high serum non-HDL-C levels and neurological impairment in acute ischemic stroke.Results Patients with high level of serum non-HDL-C had bigger body mass index(24.46 ± 11.26 vs 25.37 ± 3.33;t =-3.122,P= 0.002),higher NIHSS(3.33 ± 2.24 vs 3.75 ± 3.61;t =-5.978,P= 0.000)and CSS(4.91 ± 4.48 vs 6.56 ± 5.27;t =-4.035,P= 0.010)scores,lower ESS(91.10± 7.60 vs 87.19 ± 10.02;t = 5.347,P= 0.000)and BI(86.23± 10.37 vs 80.59 ± 14.03;t = 5.589,P= 0.000),elevated TC(3.84± 0.56 vs 5.52 ± 0.90;t =-28.276,P= 0.000)?TG(1.32 ± 0.63 vs 1.96 ± 1.31;t=-8.120,P= 0.000)?LDL-C(2.19 ± 0.47 vs 3.37 ± 0.80;t =-23.083,P= 0.000)?Hcy(13.70 ± 7.95 vs 15.27 ± 9.84;t =-2.106,P= 0.036)?FPG(6.05 ± 2.32 ?6.63± 2.84;t =-2.611,P= 0.009)?HbA1c(6.23 ± 1.30 vs6.63 ± 1.49;t =-3.204,P= 0.001),lower HDL-C(1.08± 0.26 vs 1.13 ± 0.25;t =-2.469,P= 0.014)levels.The NIHSS scores changed corresponding with serum non-HDL-C level in acute ischemic stroke patients,the total scores of NIHSS(r = 0.252,P =0.000)and CSS(r =0.187,P =0.000)were positively correlated with the serum non-HDL-C level,and the total scores of ESS(r =-0.238,P =0.000)and BI(r =-0.209,P =0.000)were negatively correlated with it.The mean score of NIHSS and CSS increased gradually with non-HDL-C levels(P = 0.000).High serum levels of non-HDL-C was an independent risk factor for neurologic impairment in patients with acute ischemic stroke,when serum non-HDL-C elevated to borderline high level,the risk of neurologic impairment significantly increased,and the risk of neurological impairment in acute ischemic stroke increased significantly as non-HDL-C levels increased.Conclusions Serum non-HDL-C concentration was associated with risk of neurological impairment after acute stroke,and the higher the serum non-HDL-C concentration,the more severe the neurological impairment increased.Serum non-HDL-C level was an independent risk factor for neurologic impairment in patients with acute cerebral ischemia,it would be an effective indicator,and target of the prevention and treatment as well,of risk prediction for neurologic impairment in patients with acute cerebral ischemia in clinical work.