| Background:Stroke is a disease with high disability and mortality,which seriously threatens human life and health.At present,the population of our country is aging,and the incidence of stroke patients is high every year,and the trend is increasing.Ischemic cerebrovascular disease is the most common type of stroke.Despite the continuous development of medical technology,there is still a lack of effective clinical treatment measures.Therefore,it is necessary to find out the risk factors of the disease and implement targeted treatment.In recent years,the role of lipoprotein(a)[Lp(a)],hyper-sensitive C reactive protein(hs-CRP)in the occurrence and development of atherosclerosis and cardiovascular and cerebrovascular diseases has been more and more recognized,but their research on intracranial and extracranial arterial diseases and specific pathogenesis is still not accurate.Objective: To investigate the relationship between serum LP(a),hs-CRP and carotid atherosclerosis in patients with acute ischemic cerebrovascular disease.Methods: Retrospective analysis of 188 patients with acute ischemic cerebrovascular disease who were hospitalized in the Second Hospital of Jilin University from October 2017 to December 2018(admitted to hospital within 72 hours of onset and peaked in disease)and 192 healthy controls in the same period,extracting past patient history,serum lipoprotein(a)[Lp(a)],total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-CRP)and other blood indicators as well as magnetic resonance angiography(MRA)and carotid ultrasound results.All statistics were analyzed by the SPSS20.0 software.Results:1.There was no significant difference in age(P = 0.52)and sex(P = 0.13)between the experimental group and the control group(P > 0.05).The risk factors of hypertension,diabetes mellitus,smoking and drinking history in the experimental group and the control group were significantly different(P < 0.05).There were significant differences in LDL-C,TC,Lp(a),hs-CRP and Hcy between the two groups(P < 0.05).HDL-C and TG of the experimental group and the control group increased,but there was no significant difference between the two groups(P > 0.05).2.The levels of LDL-C,Lp(a),hs-CRP and Hcy of cerebral infarction carotid atherosclerosis group were higher than those of carotid non-atherosclerosis group(P<0.05).Compared with the normal intima group,the serum Hcy increased in the intima thickening group(P < 0.05).There was no significant difference in LDL-C,Lp(a)and hs-CRP(P > 0.05).The serum LDL-C and Lp(a)increased in the plaque forming group compared with the normal intima group(P < 0.05).There was no significant difference in hs-CRP and Hcy(P > 0.05).There was no significant difference in serum LDL-C,Lp(a),hs-CRP and Hcy between plaque formation group and intimal thickening group(P > 0.05).3.Carotid artery stenosis group: Compared with mild stenosis group,serum LDL-C,Lp(a),hs-CRP and Hcy in moderate stenosis group had no significant difference(P > 0.05);serum LDL-C,Lp(a)in severe stenosis group and occlusion group had significant difference(P < 0.05),but serum hs-CRP and Hcy had no significant difference(P > 0.05).Compared with moderate stenosis group,serum Lp(a)increased significantly in severe stenosis and occlusion group(P < 0.05).The average levels of LDL-C and hs-CRP in patients with severe stenosis were higher than those of moderate stenosis and mild stenosis.4.Compared with the stable plaque group,the serum Hcy of no-stable plaque group increased significantly(P < 0.05),but there was no significant difference in LDL-C,Lp(a),hs-CRP > 0.05.5.With carotid atherosclerosis as dependent variable,Lp(a),hs-CRP and other related factors as independent variables,multivariate logistic regression analysis showed that age,hypertension,diabetes,smoking,TC,Lp(a)and Hcy were independent risk factors for carotid atherosclerosis(P<0.05).Conclusion:1.The elevated levels of serum Lp(a)and hs-CRP may be related to the occurrence of acute cerebral infarction.2.Elevated levels of serum Lp(a)and hs-CRP may be associated with carotid atherosclerosis,and Lp(a)is an independent risk factor for carotid atherosclerosis.3.The increase of serum Lp(a)level may be related to the severity of carotid intimal lesions,and positively related to the degree of carotid stenosis.There is no clear positive correlation between the increase of hs-CRP level and the degree of carotid intimal lesions and carotid stenosis.4.There was no significant correlation between the increase of serum Lp(a)and hs-CRP levels and the stability of carotid plaque. |
PDF Full Text Request