Clinical Study Of Serum ACA In Patients With Ischemic Cerebrovascular Disease

Stroke, the common and multiple disease in nervous system, is one of the worst harmful diseases, which is high in the rate of morbidity,recurrence, fatality, and disability.75-85% of stroke is occupied by ischemic cerebral disease. It is predicted that ischemic cerebral disease will become the main cause of disability in the developing country. Because there is no ideal therapeutic method to ischemic cerebral disease, it is important to explore risk factors and restrain them in order to descend the morbidity and improve the prognosis.The risk factors of ischemic cerebrovascular disease including atherosc- lerosis , hypertension , diabetes , cardiac disease,hyperlipemia , smoking and excessive drinking are generally acknowledged.But,traditional risk factors,for example hypertension, diabetes and so on, only explain 1/3 of stroke events, rare factors play an important role in the pathogenesis of ischemic cerebrovascular disease, including antiphospholipid antibodies (APA), hyperhomocysteinemia (Hhcy),lysophosphatidic acid (LPA) and so on.Studies of antiphospholipid antibodies (APA) in the pathogenesis of ischemic cerebrovascular disease(ICVD) have been paid more and more attention.APA is a kind of heterogeneous antibodies for phosphatide or complex of phosphatide and proteinum with negative chargeon, including anticardiolipin antibodies(ACA),lupus anticoagulant(LA),anti-phosphatidylserine,anti-phosph- atidylinositol and anti-phosphatidic acid and so on. ACA is the most common antiphospholipid antibodies, and is also notate antibody of anti-phospholipid antibody syndrome (APS). ACA is a kind of autoimmune antibodies,as a target antigen with cardiolipin with negative chargeon on platelets and endothelial cellular membrane.Immune typies of ACA incloud IgG,IgA and IgM, and Its incidence is no significant difference between men and women.When organism subjects certain disease, and normal cells in internal corresponding organizational structure are damaged, cellular membrane cuorin exposes,produces antigenicity of own organism,and stimulates organism to produce anticardiolipin antibodies. These antibodies,which are kinds of autoimmune antibodies, can identify cardiolipin with negative chargeon,and the both happen cross-immune reaction. ACA plays a role by interfering with phospholipid-dependent coagulation and anticoagulation factors to promote the formation of thrombus.Effect of ACA in arterio-venous thrombosis has been paid more and more attention,However, the relationship between ACA and ICVD has be further studied. Therefore, study of ACA in patients with ICVD,not only is able to clear the causes of some patients, but also provide theoretical basis for further guiding clinical treatment.we plan to research the relationship between the level of serum ACA and ICVD in order to establish new rationale of prevention and treatment for stroke.We chose 69 patients with ischemic cerebrovascular disease,including 32 with ICVD in young adults and 37 with ICVD in old adults,48 with ACI group and 21 with TIA group,21 with multifocal cerebral infarction group and 20 with monofocal cerebral infarction group and 25 normal control group from 2008.7-2008.12 at the department of neurology and policlinic in China Japan Union Hospital of Jilin University.All patients accorded with the diagnostic standard of the national fourth Meeting of cerebrovascular disease in 1996. onset duration of cerebral infarction patients were within 72 hours.These detects were done in all ICVD case: blood sugar by glucose oxidase method,blood lipids by enzyme, FIB by turbidimetric method,level of ACA by ELISA method; such as smoking, drinking, hypertension, diabetes and coronary artery disease, were also recorded. The research analysed correlation between traditional risk factors and corresponding laboratory indexs and ICVD, the relationship between level of serum ACA and age, sex, ICVD type,and number of cerebral lesions in patients with ICVD,and correlation between level of serum ACA and traditional risk factors.Result:There was statistic difference in traditional risk factors and corresponding laboratory indexs between ICVD group and the control group(p<0.05),however, there was no significant difference in above-mentioned indexs between young group and old group(p>0.05). The level of serum ACA in the ICVD group were significantly higher than the control group, the level of serum ACA in young adults group with ICVD were higher than old adults group (p<0.05), the level of serum ACA in ACI group was higher than TIA group(p<0.05), the level of serum ACA in multifocal cerebral infarction group was significantly higher than monofocal cerebral infarction group(p<0.05),however,there was no significant difference in the level of ACA between male group and female group(p>0.05).The level of ACA were closely positive assoeiated with TG(p<0.01),and negative correlation with HDL-C,ApoA1(p<0.01),but the level of serum ACA had no association with other risk factors. Multivariable logistic regression showed the raising of serum ACA may be risk factor of ischemic cerebrovascular disease.Conclusions: The rising of the level of serum ACA is one of the risk factors of ischemic cerebrovascular disease, especially in young adults. ACA is closely related with cerebral infarction, and especially multifocal cerebral infarction. The raising of serum ACA may be cooperated with blood fat to promote the formation and progress of thrombosis.On the whole, ACA is closely related with ischemic cerebrovascular disease, often found in multifocal cerebral infarction, and is especially an important risk factors of ICVD in young adults.Therefore, we can routinely examine ACA and give intervention to have a certain significance for preventing relapse of ICVD.