| Objective:With the change of people,s life-style and the appearance of social aging,cerebrovascular disease has become the first cause of death in China.Chinese stroke register in 2006 showed that,despite the people of spontaneous intracranial hemorrhage were decreasing,patients of cerebral infarction were increasing year by year,and the high morbidity、high disability rate and high death rate brought heavy financial burden and great pain to our society、their family and the patients themselves.Therefore,there is no time to delay to look for the efficient prevention and control to cerebral disease,and give people early discovery、early diagnosis and early treatment.Atherosclerosis cerebral infarction is the most common form in cerebral infarctions,and the blood lipid metabolic abnormity is one of the main risk factors of atherosclerosis.As is known,the high-density lipoprotein cholesterol is the only protective factor of anti-atherosclerosis by now,and the low-density lipoprotein cholesterol is a specific risk factor to atherosclerosis.The non-high-density lipoprotein cholesterol is a mixture,which is comprised by much atherogenic cholesterol,including all the lipid of specific or potential threatening to atherosclerosis.The atherosclerosis index is a comprehensive index to reflect the blood lipid metabolic abnormity,and it can measure the degree of atherosclerosis.Blan and the like put forward the conception of atherosclerosis index by studying on large sample in 2010,and defined it a ratio of the count of serum total cholesterol to minus high-density lipoprotein cholesterol to divide the high-density lipoprotein cholesterol.The bigger the number of atherosclerosis index,there is more serious of the atherosclerosis degree,and higher risk of cerebrovascular disease.There are many studies at home and abroad show that non-high-density lipoprotein cholesterol is a better value than low-density lipoprotein cholesterol to predict the morbidity and the death rate in coronary atherosclerotic heart disease.And there are also some studies show that atherosclerosis index is a better value than triglyceride、total cholesterol、high-density lipoprotein cholesterol 、 low-density lipoprotein cholesterol in assessing the risk degree of coronary atherosclerotic heart disease.But there few studies for the relationship of non-high-density lipoprotein cholesterol and atherosclerosis index to ischemic cerebrovascular disease.The aim of the study is to analyze the correlation of non-high-density lipoprotein cholesterol and atherosclerosis index with ischemic cerebrovascular disease,and combine them with other risk factors of atherosclerosis,consummate the prediction mechanism and degree assessment to ischemic cerebrovascular disease,provide more effective prevention strategies,thus to decrease the morbidity of ischemic cerebrovascular disease.Methods:171 first-ever acute cerebral infarction patients from 2015 November to2016 April in the Neurology Department of the second hospital of Qinhuangdao were selected to the treatment group,and 136 healthy people who had physical examination at the same time were selected to the matched group.All the acute cerebral infarction patients adopted head CT and/or MRI,and the diagnosis adopts the standard 《 Chinese acute cerebral arterial thrombosis diagnosis and treatment guide 2014》.Patients with serious heart and kidney disease 、 cerebral embolism with explicit embolus source 、autoimmune disease、taking orally lipid-lowering medicine in the three months and who can,t cooperate or the information was not complete,were excluded.With their informed consent,their information was collected,for example,the demographic characteristics(age,sex,height,weight,et al)、blood vessel risk factors(hypertension,diabetes,heart disease,previous stroke history,smoking history,drinking history,et al)and taking medicine orally(whether lipid-lowering medicines or other medicines were took orally in the three months).And their venous blood was collected,blood glucose、lipid、hepatic and renal function and some other biochemical criterion were tested by full-automatic biochemistry analysis meter.The non-high-density lipoprotein cholesterol was calculated by Frost method.And patients in the treatment group adopted head MRA or CTA vascular test.The carotid intima-media and plaque were tested by color flow doppler sonography PHILIP i E33 made in America and α 10 made in Japan.The data was treated statistically by SPSS22.0 software package.Results:1.The contrast of their basic information: From the contrast of sex and age constituent ratio in the treatment group and the control group,there is no statistical significance for the difference(P>0.95,P=0.335);The contrast of BMI、the rate of hypertension、 diabetes、whether with smoking and drinking history in the groups,shows that the differences have statistical significance(all the P<0.05).2.The contrast of homocysteine 、 total cholesterol 、 triglyceride 、high-density lipoprotein cholesterol 、 low-density lipoprotein cholesterol 、non-high-density lipoprotein cholesterol 、 atherosclerosis index in the two groups: The levels of total cholesterol and triglyceride are similar:(4.86±0.08mmol/l)vs(4.65±0.07mmol/l)and(1.78±0.06mmol/l)vs(1.67±0.07 m mol/l),all the differences have no statistical significance(P=0.123,P=0.239);Compared with the control group,the level of some indexes in the treatment group are significantly higher,such as the homocysteine levels are(14.76±0.60mmol/l)vs(11.88±0.50mmol/l),the low-density lipoprotein cholesterol levels are(2.73±0.06mmol/l)vs(2.54±0.05mmol/l),and the non-high-density lipoprotein cholesterol levels are(3.79±0.08mmol/l)vs(3.45±0.07mmol/l);the atherosclerosis index levels are(3.68±0.10)vs(2.98±0.08),for that(P<0.05,P=0.034,P=0.006,P<0.005).But the level of high-density lipoprotein cholesterol in the treatment group is lower than it in the control group,the contrast is(1.07±0.01mmol/l)vs(1.20±0.02mmol/l),the difference is of statistical significance(P<0.05).3.The contrast of non-high-density lipoprotein cholesterol and atherosclerosis index in the group of patients with cerebral infarction in three different squads,divided by the carotid artery color ultrasound showing carotid intima-media incrassation squad、plaque squad、stenosis squad: The levels of non-high-density lipoprotein cholesterol in the three different squads are(3.72±0.16mmol/l)vs(3.75±0.12mmol/l)vs(3.77±0.18mmol/l),and the levels of atherosclerosis index are(3.47±0.19)vs(3.65 ±0.15)vs(3.50±0.24).Though the differences are of no statistical significance(P > 0.05),the quantitative values have an ascending tendency.4.The contrast of non-high-density lipoprotein cholesterol and atherosclerosis index in different sexes and in different groups: In the treatment group,the levels of non-high-density lipoprotein cholesterol and atherosclerosis index in the male group and in the female group are(3.70±0.10mmol/l)vs(3.94±0.13mmol/l)and(3.71±0.13)vs(3.65±0.14).And in the control group,the contrasts are(3.34±0.10mmol/l)vs(3.53±0.10mmol/l)and(2.95±0.12)vs(3.00±0.11),which shows that,there is no statistical significance(P>0.1).Conclusion:Hypertension、diabetes、smoking、high total cholesterol and low-density lipoprotein cholesterol are all the risk factors to atherosclerosis;Non-high-density lipoprotein cholesterol is an independent risk factor to atherosclerotic cerebrovascular disease.Atherosclerosis index is a risk factor to atherosclerosis,having a very strong correlation to the degree of atherosclerosis.The levels of non-high-density lipoprotein cholesterol and atherosclerosis index in the male group and in the female group are of no difference,needing a big sample experiment to study. |
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