Research Of The Relationship Between Serum Levels Of Lp-PLA2,Hs-CRP And Ox-LDL And Vascular Recanalization Rate,Severity Of Illness And Prognosis Of AIS Patients

Acute ischemic stroke(AIS)is a disease that leads to disability and death.Atherosclerosis(AS)is an important risk factor of AIS.Large-artery atherosclerosis(37.3%)was the most common stroke subtype in the TOAST classification of AIS.The occurrence of the AS is a chronic inflammatory process,the study found that serological inflammatory markers lipoprotein-associated phospholipase A2(Lp-PLA2),hypersensitive c-reactive protein(Hs-CRP)and oxidized low density lipoprotein(Ox-LDL)can lead to the occurrence and development of AS through different mechanisms.The serum levels of the above three substances were significantly increased in the acute stage of AIS,and their contents were in direct proportion to the severity of the AIS.In our study,serum levels of Lp-PLA2,Hs-CRP and Ox-LDL were detected to further study the relationship with the vascular recanalization rate and prognosis in AIS patients,providing a strong basis for the clinical value of treatment and prognosis in the hyperacute stage of AIS.Patients with mechanical thrombectomy(MT)and intravenous thrombolysis admitted to the department of neurology of the first affiliated hospital of Hebei North University from March 2018 to October 2019 were retrospectively analyzed.According to different treatment regiments,the patients were divided into three groups: direct thrombectomy group(MT group for short),venous thrombolysis bridge thrombectomy group(bridge group for short)and venous thrombolysis group(thrombolysis group for short).Each group was further divided into vascular recanalization and vascular unrecanalization subgroups and good prognosis and poor prognosis subgroups.Among them,40 cases in the MT group,20 cases in the bridge group and 40 cases in the thrombolysis group.40 cases of AIS patients who refused intravenous thrombolysis and(or)MT treatment admitted to our hospital at the same time were included as the control group.Serum Lp-PLA2,Hs-CRP and Ox-LDL levels were measured at admission for all patients,and AIS severity was assessed according to the national institutes of health stroke scale(NIHSS)score.Postoperative vascular recanalization rate of patients in each group was calculated.The modified Rankin scale(m RS)at the 90 d follow-up was recorded to assess the prognosis of the patients.The levels of Lp-PLA2,Hs-CRP and Ox-LDL in each group were positively correlated with NIHSS score(P<0.05).The levels of Lp-PLA2,Hs-CRP and Ox-LDL in vascular recanalization subgroup of the MT group and the bridge group were significantly lower than those in the vascular unrecanalization subgroup(P<0.05).The levels of Lp-PLA2,Hs-CRP and Ox-LDL in the good prognosis subgroup were significantly lower than those in the poor prognosis subgroup of each group(P<0.05).In conclusion,the Lp-PLA2,Hs-CRP and Ox-LDL levels are positively correlated with the severity of the AIS patients,which is of guiding significance for the AIS evaluation.The levels of Lp-PLA2,Hs-CRP and Ox-LDL were negatively correlated with the rate of vascular recanalization rate and good prognosis rate of AIS treated by MT and intravenous thrombolysis,suggesting that they might be a potential clinical intervention direction of AIS.