| Objective: To investigate the correlation between the level of serum lipoprotein a(LP(a)),low density lipoprotein(LDL-C),homocysteine(Hcy)and cystatin C(CysC)with the early diagnosis of acute cerebral infarction(ACI).Methods: A total of 300 ACI patients admitted to the Department of Neurology and General Medicine of our hospital from January 2019 to May 2020 were selected into the case group.After detailed medical history and physical examination,the NHISS scale was used to assess the degree of neurological impairment and divided into three groups:mild,moderate,and severe.At the same time,70 patients with no history of cerebral infarction were selected as the control group.Collect the general conditions(Including gender,age,smoking status,high blood pressure,diabetes history,etc.)and the levels of relevant biochemical indicators(Including serum cholesterol(CHOL),triglycerides(TG),Glucose(Glu),high-density lipoprotein(HDL),LP(a),LDL-C,Hcy and CysC)of all samples in the case group and the control group.Use our hospital’s automatic biochemical analyzer and its supporting detection reagents for determination.Fasting for 12 hours before the test,and draw about 4ml of venous blood under an empty stomach,and then centrifuge and take the serum for test.The correlation between serum LP(a),LDL-C,Hcy and CysC and ACI and its severity was analyzed by statistical methods,and the early diagnosis value of the above indicators in ACI patients and their influence on the prognosis were further analyzed.Results:1.There was no significant difference in gender,age and TG level between the two groups(P>0.05);the proportion of smoking,hypertension and diabetes in the case group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The serum CHOL,GLU,LP(a),LDL-C,Hcy,CysC levels of ACI patients were higher than those of the control group,while the HDL level of the control group was higher than that of the case group,the difference was statistically significant(P<0.05).2.Serum LP(a),LDL-C,Hcy levels were positively correlated with the severity of ACI,and the difference was statistically significant(P<0.05).There is no correlation between serum CysC and the severity of ACI.3.The area under the ROC curve(AUC)of serum LP(a),LDL-C,Hcy,and CysC for the diagnosis of ACI are 0.793,0.758,0.662,0.799,respectively;and the model constructed based on the different indicators of serum LP(a),LDL-C,Hcy,and CysC is more accurate than a single indicator in diagnosing ACI,especially the four-factor model(the area under the ROC curve is 0.841).Among the four indicators,the sensitivity and specificity of Hcy alone in the diagnosis of ACI were higher,81.00% and 88.53%,respectively;while Model 11 had the highest sensitivity and specificity in the diagnosis of ACI,97.14% and 90.63%,respectively.The Youden Index of the Model 11 is87.77%.4.Serum LDL-C and Hcy are related to the prognosis of ACI;the higher the level,the worse the prognosis of acute cerebral infarction(P<0.05).Serum LP(a)and CysC levels have no significant correlation with the prognosis of ACI(P>0.05).Conclusion:1.Serum LP(a),LDL-C,Hcy and CysC levels are related to the occurrence of ACI,and they are all risk factors for ACI.2.Serum LP(a),LDL-C,Hcy levels are positively correlated with the severity of ACI,which can be used as indicators to evaluate the severity of ACI.3.Combined serum LP(a),LDL-C,Hcy and CysC levels have higher accuracy in the diagnosis of ACI,which may be used as a biological indicator for early diagnosis of ACI.4.Serum LDL-C and Hcy may be used as evaluation indicators for the prognosis of ACI patients. |
PDF Full Text Request