| Objective: Acute ischemic stroke is diagnosed with physical examination,CT scan,and MRI scan.However,CT has low sensitivity and specificity,and MRI is expensive and hysteretic.Diagnostic serum biomarkers may be in urgent need of clinic.We sought to study the relationship between Lp-PLA2 levels and the diagnosis and subclassification of acute ischemic stroke within 3 days of symptom onset,and to explore a new method of serum biomarker useful for diagnosis,as well as provide more theoretical foundation for individualized treatment.Methods: 1 materials 1.1 Research SubjectsPatients who presented to the neurology department of the second hospital of Hebei Medical University within 72 hours after onset of symptoms from December 2014 to December 2015 and diagnosed acute ischemic stroke were considered as observation group.Meanwhile,90 healthy examinees were selected as normal group.The observation group had 90 cases(male 74 cases,female 16 cases),including 66 cases of first onset and 24 cases of recurrence,aged 45-80 years old(mean age 58.58±8.46).The control group had 90 cases(male 74 cases,female 16 cases),aged 45-80 years old(average age 62.84±9.03).1.1.1 Inclusion and exclusion criteria of the research objectInclusion criteria:1)All observation group patients met the key points for diagnosis of cerebral vascular diseases formulated by the Fourth National Conference On Cerebrovascular Diseases,and were confirmed by brain MRI+DWI+MRA;2)Aged 45-80 years;3)Within 3 days of symptom onset;4)Signed the informed consent.Exclusion criteria: 1)Aged < 45 years old or > 80 year old;2)The observation group beyond 3 days after symptoms onset;3)The observation group patients who unable to perform the brain MRI;4)Suffered from cerebral hemorrhage,subarachnoid hemorrhage,cerebral Venous(sinus)thrombosis and other vascular disease;5)Complicated with acute coronary syndrome;6)Complicated with serious heart,liver,lung or kidney functional lesion,and pregnancy,trauma,tumor and autoimmune diseases;7)Did not sign the informed consent.1.1.2 The classification of observation groupAccording to Chinese Ischemic Stroke Subclassification,the observation group was further divided: 1)Large artery atherosclerosis(LAA),including atherosclerosis of aortic arch and intra-/extracranial large arteries,having totally 56 cases;2)Penetrating artery disease(PAD),including 23 cases in total;3)Cardiogenic stroke(CS),having 4 cases altogether;4)Other etiology(OE),having none;5)Undetermined etiology(UE),including 7 cases in all.2 Experimental methods 2.1 Sample collectionBlood samples of fasting vein blood 3ml were collected within 24 h of admission,and anticoagulated by ethylenediaminetetraacetic acid(EDTA).The measurement of Lp-PLA2 level was finished in 5 hours.2.2 The detection of Lp-PLA2 levelThe NORMAN series scattering turbidity analyzer and Lipoprotein phospholipase A2 assay kit was produced by Nanjing Norman Biological Technology Co.,Ltd.The process of enhanced immuno-nephelometric assay was according to the kit instructions.The deter-mination of Other biochemical indicators,like Chol、TG、LDL-C、HDL-C、Hcy and hs-CRP level,were measured by the American automatic biochemical analyzer.3 Statistical analysisData analysis was performed with statistical software(SPSS Statistics for Windows,version 21.0).The data of normal distribution were reported as mean ± standard deviation as average results,and the data of non-normal distribution was describe as median(interquartile spacing).The two groups of normal distribution were compared with t test,and the non-normal distribution with rank sum test.Kruskal-Wallis test was used for the comparison between two groups of one-way ordinal rank data.And the Spearman rank correlation coefficient was used to describe the correlation of ranked data.χ2 test was used for the comparison of count data.Statistical significance was defined by P < 0.05.Results:1 The age,the sex ratio and the proportion of drinking between the observation group and the control group were no statistic difference(P > 0.05).Whereas,the proportion of smoking,hypertension and diabetes were statistically significant in two groups(P < 0.05).2 The levels of plasma TG,LDL-C between the observation group and the control group were no statistic difference(P > 0.05).Chol and HDL-C levels were statistically significant(P < 0.05).3 The level of Lp-PLA2 level in the observation group and control group was no statistic difference(P > 0.05).4 Male and female patients in observation group were compared with the male and female patients in control group respectively,(P > 0.05),there was no significant difference in Lp-PLA2 level.5 Compared first onset acute ischemic stroke,recurrent acute ischemic and control group respectively,there were no significant difference(P > 0.05).6 The Lp-PLA2 level of LAA group,PAD group,and control group were compared with each other according,the difference was no statistically significant difference(P > 0.05).7 The Lp-PLA2 level was significantly positively correlated with hs-CRP(P < 0.01).The time of symptoms onset,age,hypertension,diabetes,smoking,drinking,TG,Chol,LDL-C,HDL-C and Hcy were not significantly correlated with Lp-PLA2 level(P > 0.05).Conclution : The Lp-PLA2 level can’t predict the diagnosis and subclassification of acute ischemic stroke in Han population,and the Lp-PLA2 level is significantly positively correlated with hs-CRP. |
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