The Correlation Between Lipoprotein(a) And The Intracranial And Extracranial Narrow Arteries In The Patients With Stroke And The High Risk Factors Of Stroke And The Analysis Of The Elements Of Syndrome

ObjectiveThis study usethe prospective and retrospective analysis respectively.To compare the different of the risk factors of stroke group,the first ischemic stroke group and recurrence of ischemic stroke in lipid composition and to summarizedthe syndrome elements in the three groups.Another one is to explorate the correlation between the lipoprotein(a)and different disease groups in extra-or intercranial atherosclerosis and describe the characteristics of syndrome elements.The correlation that between lipoprotein(a)and different stroke groups is discussed and the distribution of the characteristics of syndrome elementsare discussed too.MethodsThere were 207 persons that were collected fromthe Medical Center of Guangdong Prevence Hosipital between January 2015 and December 2015.And there were 236 patients who were the first stroke,126 patients who were the recurrent stroke that were collected from the Eirst Brain Office ofGuangdong Prevence Hosipital between January 2015 and December 2016.Analysis the difference of lipoprotein(a)in the different levels of atheroclersis in artery.At the same time,thecorrelation would be finded between lipoprotein(a)and atherosclerosis.The correlation between lipoprotein(a)and syndrome elermrnts was be detected too.Results1.In the group of high Risk factors,the sequence of TCM syndromeis:qi deficiency syndrome(54.96%),phlegm syndrome(47.83%),blood stasis syndrome(33.82%),and qi stagnation syndrome(11.11%),Yang deficiency syndrome(11.11%),fire syndrome(10.14%).2.There is no difference during the different level of cardio artery atherosclerosis.When the happening of atherosclerosis,the compose of syndrome of Qi deficiency is rising(28.89%VS 34.89%,28.89%VS 34.89%).3.lipoprotein(a)show a significant difference in the differencre level of cardio artery atherosclersis(P<0.05,P<0.05).Lipoprotein(a)was positively correlated with carotid artery atherosclersis(P<0.05,OR:1.003,95%CI:1.001-1.005);Lipoprotein(a)was positively correlated with carotid artery plaque(P<0.05,OR:1.005,95%CI:1.001-1.009);Lipoprotein(a)with carotid intima-media thickness combined plaques were positively correlated(P<0.05,OR:1.005,95%CI:1.005-1.009).4.Lipoprotein(a)had a positive correlation with qi deficiency syndrome(P<0.05,OR:1.000,95%CI:1.000 1.003)in the high risk factors group.5.Lipoprotein(a)showed a significant different in the different level of intercranical artery atherosclerosis(P<0.05).When the intracranial artery stenosis>75%,the difference is statistically significant(P<0.05),and was positively correlated with plasma lipoprotein(a)(P<0.05,OR:1.003,95%CI:1.000 1.005).6.The first stroke group comparedwith the recurrent group involving artery stenosis group with statistical differences(P<0.05).the two groups had a statistically significant(p = 0.042<0.05)in the stroke subtype.For the further study,the recurrence stroke in patients with lacunar cerebral infarction was more than the first.In the first stroke group the group of SOEwas more than recurrence stroke.In the two groups,the highest stroke type was artery atherosclerotic cerebral infarction(LAA)(65.86%,63.89%).7.The first group of qi deficiency syndrome of stroke was 3.01%,recurrence of stroke group of deficiency syndrome was 8.19%,higher than the first stroke group,and the difference between the two groupswas statistically significant(P<0.05).But the main syndrome elements in the two groupswere wet phlegm syndrome,blood stasis syndrome and the wind.The blood stasis syndrome,and the wind were lower(32.76%VS 34.45%,25.94%VS 31.27%)in therecurrence of stroke group.8.The first stroke group was divided into three groups:≤50%,50%<stenosis≤75%,>75%.Only lipoprotein(a)shows a significant difference in the three groups(P<0.05),and has a positively corraltion with artery stensis(P<0.05,OR:1.003,95%CI:1.000 1.005).More obvious of the difference is in harmony with the increasing number of the atherosclerotic artery.When the number of atherosclerotic artery was more than 3,lipoprotein(a)showed a positive correlation(P<0.05,OR:1.01,95%CI:1.00 1.01).9.The recurrent stroke group was divided into two groups:into three groups:≤50%,50%<stenosis≤75%,>75%acrroding the intercranial artery atherosclerosis.Lipoprotein show a significant difference in the threegroups(P<0.05).More obvious of the difference is in harmony with the increasing number of the atherosclerotic artery.When the number of atherosclerotic artery was more than 2,lipoprotein(a)showed a significant difference(P<0.05)and a positive correlation(P<0.05,OR:1.03,95%CI:1.01 1.29).10.With the increasing of lipoprotein(a),the composition of Qi deficiency syndrome was increasing,too.Conclusion1.Lipoprotein(a)was the independent risk factors for atherosclerosis and was significant positively relationship with the cardio artery in high risk factors and the intercranial artery in the stroke group,2.When the intracranial artery stenosis in ischemic stroke group is over 75%,the lipoprotein(a)only showed statistical different,and positively correlated with degree of stenosis,and the first stroke group and the’recurrent stroke group still maintain difference and correlation with the degree of atenosis.Lipoprotein(a)in the same stage of stroke of intracranial artery stenosis>75%showed higher sensitivity and specificity.3.Phle;gm syndrome,blood stasis,qi deficiency syndrome exits in every stage of stroke.Qi deficiency syndrome,ph1egmsyndrome,blood stasis syndrome made up the main syndrome in the high risk group.Phlegm syndrome,blood stasis,wind syndrome,qi deficiency made up the main syndrome in the first stroke group.The deficiency syndrome elements was the main factor in the high risk factor group,and many kinds of evil was the main composition inthe stroke group companied with qi deficiency.In the first and recurrent stroke group,the elevating concerntration of lipoprotein(a)accompany with the change of element syndrome.4.In the high risk factor group,qi deficiency was positively associated with elevated lipoprotein(a).In the first stroke group and the recurrence of ischemic stroke group the increased lipoprotein(a)accompanied with qi deficiency syndrome rising.Qi Deficiency syndrome seemed to predict the change of lipoprotein(a),and then predict the degree of atherosclerosis in the different groups.