The Correlation Research Of Glycosylated Hemoglobin, Lipoprotein(a) And Ischemic Cerebrovascular Disease

Cerebrovascular is a clinically common and multiple neurological diseases. With the prolonging of human average life and rapid development of aging society, the incidence of ischemic cerebral vascular disease has increased significantly, which accounts for 67.3%-80.5% of all cerebrovascular diseases by related analysis data. It has become an important factor impacting our health and life quality.Nowadays ischemic cerebrovascular disease is becoming a focus for many researches due to its high incidence. Diabetes has been commonly regarded as a risk factor of vascular disease by present researches. Lipoprotein(a) is confirmed as a new risk factor of cardiovascular disease in recent years, but it is disputed due to its role in the onset of cerebral apoplexy. The epidemiology studies have proved that lipoprotein(a) levels have a continuous, independent and medium intensity relationship with cardiopathy and ischemic cerebrovascular. According to the Adult Education Treatment Guide of U.S. Nation Cholesterol Plan, lipoprotein(a) is classified as an emerging risk factors of lipids.Objective: The research mainly evaluates the relationship between glycosylated hemoglobin, lipoprotein(a) and the severity of neurologic impairment. It aims at providing a convincing judgment for diagnosing of ischemic cerebrovascular disease, improving the treatment effect and prognosis.Methods: Retrospective study is used in this research, which has collected 273 cases of ischemic cerebrovascular diseases that were treated in the Second Hospital of Shijiazhuang nerve internal medicine during December 2013 to December 2014, and all the cases met the standards established by The Fourth National Cerebrovascular Disease conference, with initial onset, and were confirmed by the head CT or MRI. It has collected detail information of all the patients, including age, gender, diabetes, hypertension and smoking habit, tested the patients’ biochemical indicators of hemoglobin, lipoprotein(a), cholesterol, high-density lipoprotein, low density lipoprotein and etc. The patients admitted to hospital within 24 hours, were scored respectively on the basis of the U.S. National Institutes of Health stroke scale(NIHSS), and were detected blood glucose hemoglobin and lipoprotein(a) indicators.According to NIHSS scores, the patients were divided into three groups for minor stroke(less than 5 marks), ordinary stroke(between 5 and 14 marks) and major stroke(more than 15 marks).It analyzes the difference about patient’s age in different groups with the method of ANOVA, compares the difference about patient’s gender, smoking habit and hypertension incidence in different groups with the method of Chi square test, explores the differences of patient’s glycosylated hemoglobin and the level of lipoprotein(a) among the three groups by Single Factor Analysis of Variance. It also use multiple regression analysis, which takes the NIHSS score as the dependent variable and glycated hemoglobin levels, lipoprotein(a), cholesterol, low density lipoprotein, high density lipoprotein, age, gender, history of smoking, history of diabetes, hypertension as independent variables, to analyze the relationship between glycosylated hemoglobin, lipoprotein(a) and NIHSS scores in the methods of regression analysis.Results: With 273 cases of starting ischemic cerebrovascular disease patients(according to the NIHSS scores, 87 cases of minor stroke, 101 cases of ordinary stroke, 85 cases of major stroke), it shows that the level of glycosylated hemoglobin and lipoprotein(a) are different by groups. The difference has the statistics significance(P≦0.05). And according to the regression analyzing with independent variable of other factors, it can be found that glycosylated hemoglobin and lipoprotein(a) are the risk factors of influencing the severity of neurologic defect.Conclusions: It suggests that glycosylated hemoglobin,lipoprotein(a) are associated with ischemic cerebrovascualr disease, and the higher level of both of them, the more severe neurologic is defected. The nerve function damage will be more severe when the indicators of glycosylated hemoglobin and lipoprotein(a) are both high level than just one of them. It prompt the relationship between glycosylated hemoglobin, lipoprotein(a) and ischemic cerebrovascular disease in clinical work should be paid more attention. It can predict the risk of cerebral apoplexy by measuring the two indicators of glycosylated hemoglobin and lipoprotein(a), especially provides early warning on the ischemic of cerebral apoplexy with wide lesions and high damage degree.