| BackgroundThe incidence of ischemic stroke(IS)is increasing year by year,which has become a difficult problem in the field of public health,and the incidence population is becoming younger.The etiology of IS in young patients is diverse,including specific age factors,behavioral factors,metabolic factors and environmental factors.Compared with the elderly IS,aorta and small vascular lesions cause relatively few young patients with IS,but cardiogenic embolism,rare cause type and unknown cause type are common.Actively exploring the etiology of IS in young patients has become the tireless goal of medical workers.Plasma lipoprotein-associated phospholipase A2(Lp-PLA2)is a new vasoinflammatory factor discovered in recent years,is closely related to atherosclerosis(AS)and plays an important role in the occurrence,severity and prognosis of ischemic stroke.However,its correlation with IS in young patients needs further exploration.ObjectiveTo investigate the relationship between plasma Lp-PLA2 level and IS in young patients: 1.To compare the difference of plasma Lp-PLA2 between IS in young patients and non-ischemic cerebrovascular diseases;2.The effect of plasma Lp-PLA2 level on the degree of neurological impairment of IS in young patients;3.The effect of plasma Lp-PLA2 level on short-term prognosis of IS in young patients;4.Whether plasma Lp-PLA2 levels are risk factors for IS in young patients.Materials and methodsTotally 113 young patients with ischemic stroke admitted continuously in Puyang People’s Hospital from June 2018 to December 2019 were included in the cerebral infarction group.During this period,32 patients with transient ischemic attack were included in TIA group and 34 patients with peripheral vertigo were included in vertigo group(non-ischemic cerebrovascular disease control group).The baseline data of the three groups were compared.According to the National Institutes of Health stroke scale(NIHSS)score,the cerebral infarction group was divided into the mild stroke group(NIHSS equal or less than 4),moderate stroke group(NIHSS equal or over 5 but equal or less than 15)and severe stroke group(NIHSS equal 16 or 17).Patients with cerebral infarction were followed up after three months,who were divided into good prognosis group(m RS equal or over 0 but equal or less than 2)and poor prognosis group(equal or over 3 but equal or less than 5)according to the modified Rankin Scale(m RS).Immunochromatographic method was used to detect the serum Lp-PLA2 level.Results1.The baseline data comparison showed that there was no significant difference in age and sex between the three groups(P>0.05),and The risk factors of the three groups were statistically significant(P<0.05).2.The serum Lp-PLA2 levels of cerebral infarction group,transient ischemic attack group and control group showed a decreasing trend,which were(249.47±98.24)ng/ml,(208.19±87.43)ng/ml and(149.50±73.05)ng/ml,and the difference was statistically significant(P<0.05).3.The serum Lp-PLA2 levels of severe stroke group,moderate stroke group and mild stroke group showed a decreasing trend,which were(323.67±107.96)ng/ml,(257.25±95.34)ng/ml and(206.31±85.96)ng/ml,and the difference was statistically significant(P<0.05).4.Multivariate Logistic regression analysis revealed that serum Lp-PLA2 levels,dyslipidemia,hypertension and hyperhomocysteinemia are risk factors for ischemic stroke in young patients.5.The serum Lp-PLA2 level of the group with good prognosis was lower than that of the poor prognosis group,and the difference was statistically significant(P<0.05).Conclusion1.The plasma Lp-PLA2 is a risk factor for young patients with IS;2.Plasma Lp-PLA2 levels were associated with neurological defects and short-term prognosis in young patients with IS. |
