Correlation Analysis Of Serum LP(a), VCAM, VEGF Levels And Acute Cerebral Infarction In Diabetes Mellitus Complicated

Purpose:To analyze the correlation between the levels of LP(a),VCAM and VEGF in serum and diabetes mellitus complicated with acute cerebral infarction.Methods:From October 2018 to October 2019,45 patients with diabetes complicated with acute cerebral infarction(group A),41 patients with simple acute cerebral infarction(group B),19 patients with simple diabetes(Group C)and 19 healthy controls(Group D)were selected from the second hospital of Jilin University.The patients' medical history and physical examination data were collected and recorded in detail.The levels of LP(a)and VCAM(vascular endothelial growth factor)were measured by immunoturbidimetry and ELISA.By using TCD,MRA and CTA,the degree of cerebral vascular stenosis in diabetes mellitus complicated with acute cerebral infarction group was divided into three subgroups: 4 cases in non stenosis group,8 cases in mild and moderate stenosis group,33 casesin severe stenosis or occlusion group.The hospitalized patients in diabetes mellitus complicated with acute cerebral infarction were divided into light group(NIHSS score < 7points),medium group(7 points ? NIHSS score < 15 points)and heavy group(NIHSS score ? 15 points)by NIHSS score(using NIHSS score standard questionnaire).The levels of serum Lp(a),VCAM and VEGF were compared among the four groups.The relationship between the levels of serum Lp(a),VCAM and VEGF and the degree of cerebrovascular stenosis and neurological deficit in patients with diabetes mellitus complicated with acute cerebral infarction was analyzed.The molecular biology was provided for pre clinical intervention and treatment of acute cerebral infarction from the perspective of pathogenesis Basic knowledge.Results:1.There was no significant difference in age,gender and smoking between groups A,B,C and D.2.The comparison of LP(a)and VCAM in diabetes with acute cerebral infarction group,simple acute cerebral infarction group,simple diabetes group and control group: the serum Lp(a)and VCAM in diabetes with acute cerebral infarction group,simple acute cerebral infarction group and simple diabetesgroup were higher than those in control group(P There was no significant difference between infarct group and simple diabetes group(P > 0.05).3.The level of VEGF in the serum of the diabetic patients with cerebral infarction,the simple cerebral infarction,the simple diabetes and the control group was higher than that of the control group(P < 0.05);the level of VEGF in the simple cerebral infarction group was higher than that of the diabetes patients with cerebral infarction(P < 0.05).4.The relationship between the level of LP(a),VCAM and carotid artery stenosis in diabetic patients with cerebral infarction.According to the degree of vascular stenosis,diabetic patients with cerebral infarction were divided into non vascular stenosis group,mild to moderate vascular stenosis group and severe vascular stenosis or occlusion group.The levels of LP(a)and VCAM increased with the severity of vascular stenosis in patients with diabetes mellitus complicated with cerebral infarction(P < 0.05).5.The results showed that serum LP(a)(OR = 1.029,95% CI1.011-1.051,P < 0.05),VCAM(OR = 1.051,95% CI 1.012-1.101,P < 0.05)were the risk factors of diabetes mellitus complicated with acute cerebral infarction;serum VEGF(OR=0.937,95% CI0.894-0.971,P < 0.05)is the factor to reduce the incidence of diabetes mellitus complicated with acute cerebral infarction.6.In diabetic patients with acute cerebral infarction,Spearman correlation analysis showed that serum Lp(a)(r =0.348,P < 0.05),serum VCAM(r = 0.608,P < 0.001)were positively correlated with the severity of diabetic patients with acute cerebral infarction,and serum VEGF(r =-0.943,P< 0.001)was negatively correlated with the severity of diabetic patients with acute cerebral infarction.Conclusions:1.The serum Lp(a)and VCAM levels were increased in patients with diabetes mellitus complicated with acute cerebral infarction,and may be positively correlated with vascular stenosis and severity of the disease in patients with diabetes mellitus complicated with acute cerebral infarction.2.The level of VEGF in serum decreased in patients with diabetes mellitus complicated with acute cerebral infarction,and may be negatively correlated with the severity of diabetes mellitus complicated with acute cerebral infarction.3.High concentration of LP(a),VCAM and low concentration of serum VEGF play different roles in the multi-targetmechanism(atherosclerosis,inflammatory response and collateral circulation)of diabetes mellitus with acute cerebral infarction,and have certain reference value in evaluating the severity of diabetes mellitus with acute cerebral infarction,which should be paid great attention to in clinical.