Study On The Correlation Between Serum Lipoprotein (a) Level And CISS Classification In Young Patients With Ischemic Stroke

Objective: To explore the relationship between the level of serum lipoprotein(a)[Lp(a)] and the Chinese ischemic stroke subclassification(CISS)in youg patients with ischemic stroke to provide evidence for its prevention and treatment.Methods: The clinical data of 122 young patients with ischemic stroke treated in the First Affiliated Hospital of Bengbu Medical College from April 2017 to December2019 were collected as the young stroke group,122 cases of ischemic stroke patients aged ≥ 45 years who were hospitalized during the same period were randomly admitted as the middle-aged and elderly stroke group.The differences of traditional risk factors,such as hypertension,diabetes,hyperlipidemia,history of smoking,history of drinking,history of heart diseases and family history of stroke,and serum Lp(a)levels were compared between the two groups.According to the CISS classification,pathogenesis and NIHSS scores at the time of admission,young patients with ischemic stroke were divided into groups,and serum Lp(a)levels were compared between the groups.Multivariate logistic regression analysis was used to analyze the independent influencing factors of ischemic stroke in young patients.Results:1.A total of 244 patients with ischemic stroke were included in this study,including122 cases in the young stroke group and 122 cases in the middle-aged and elderly stroke group.There were statistical differences in hypertension,hyperlipidemia,history of smoking,history of drinking,history of heart disease and Lp(a)>300mg/L(P < 0.05),but there was no statistical difference in gender,diabetes,and family history of stroke(P>0.05).2.The serum Lp(a)level in the young stroke group was(332.80±68.40)mg/L,and the middle-aged and elderly stroke group was(280.45±39.60)mg/L.The serum Lp(a)level in the young stroke group was significantly higher than that in the middle-aged and elderly stroke group(t=7.317,P<0.001).In different CISS classification,serum Lp(a)level in LAA,PAD,CS,OE,UE subtypes were(381.38± 62.46)mg/L,(297.94 ±43.97)mg/L,(283.00±39.33)mg/L,(279.25±38.22)mg/L,(292.92±34.93)mg/L,the difference between groups was statistically significant(F=22.772,P < 0.001),the serum Lp(a)level of the LAA subtype was significantly higher than that of the PAD,CS,OE and UE subtypes(P<0.05),but there was no significant difference among the other four subtypes(P>0.05).There was no significant difference in serum Lp(a)levels among patients with different pathogenesis of LAA subtype(F=0.264,P=0.851).Multivariate logistic regression analysis found that hyperlipidemia,history of smoking and Lp(a)>300mg/L are independent risk factors for LAA subtype of young patients with ischemic stroke.3.The serum Lp(a)levels of ischemic stroke in young patients with mild(NIHSS score <5),medium(NIHSS score 5-15),and severe(NIHSS score> 15)are(308.04±67.03)mg/L,(338.91±58.35)mg/L and(379.83±75.26)mg/L,the differences between groups were statistically significant(F=8.579,P<0.001),and the differences between any two groups were statistically significant(P<0.05).Conclusion: Elevated serum Lp(a)level is an independent risk factors for ischemic stroke in young people.It plays an pathogenic important role in patients with large artery atherosclerosis and can be used to assess the severity of the disease.Attention should be paid to monitoring and intervention.