The Correlation Between Low Level LDL-C And Cerebral Hemorrhage In Patients With Ischemic Stroke

Objective:By using magnetic resonance gradient echo T2 weighted imaging(GRE-T2WI)and magnetic susceptibility weighted imaging(SWl)technique,the detection of cerebral hemorrhage in patients with ischemic stroke in our department was performed,To know whether there is a correlation between the risk factors of ischemic stroke patients and cerebral hemorrhage.After intensive lipid lowering,Whether the low level of low density lipoprotein cholesterol is related to cerebral hemorrhage.Methods: The patients with acute ischemic stroke were selected from the Department of internal medicine,Hengshui Halison International Peace Hospital,from September 2014 to December 2015,156 consecutive patients.According to the patients admitted to hospital after the application of magnetic resonance gradient echo T2 weighted imaging(GRE-T2WI)and magnetic susceptibility weighted imaging(SWl)technology,detection of cerebral micro hemorrhage in the patients of the group,determine if it is accompanied by CMBs,patients in the group were divided into two groups: CMBs(62 cases)with cerebral hemorrhage(cases)and CMBs(-)group without cerebral hemorrhage group(94 cases).Detailed records of all the relevant clinical data of all patients enrolled in the group,the content included age,gender,history of hypertension,diabetes history,coronary heart disease history.Also includes a patient's previous history of stroke,smoking history,drinking history,oral anti platelet aggregation drugs and admission blood pressure and so on.All patients were in risk factors,total cholesterol,triglycerides,high density lipoprotein cholesterol,low density lipoprotein cholesterol,uric acid,homocysteine,fasting blood glucose,fibrinogen and other biochemical tests.Standard reference <Chinese ischemic stroke and transient ischemic attack two prevention guide 2010>,2013 United States AHA/ACC release of < treatment cholesterol to reduce the risk of atherosclerotic cardiovascular disease(ASCVD)guidelines >,<Guidelines for the diagnosis and treatment of acute ischemic stroke in China 2014>and< Two prevention guidelines for ischemic stroke and transient ischemic attack in China 2014>.Treatment began,the two groups were randomly divided into two subgroups: A(+)CMBs,CMBs(+)B;CMBs(-)A,B.(-)CMBs.The A group was unified into the intensive statin group,and the B group was treated as the standard lipid lowering group.Intensive lipid lowering treatment selection of Atorvastatin Calcium Capsules(You Jia),the initial dose of 60 mg once per night,after the selection of maintenance of the standard 20 mg,once a night oral;Standard lipid lowering treatment selection of Atorvastatin Calcium Capsules(You Jia),the initial dose of 40 mg per night once a day,after the standard dose of 10 mg,an oral maintenance every night.During the 1 months,3 months and 6 months after treatment,the number of intracranial CMBs foci was recorded.All data entry statistical software SPSS 17 software,measurement data using mean + standard deviation(X + S1);a group of t test was used to compare the average number of each group,and before and after treatment were compared using paired t test,measurement data between groups were compared using independent samples t test or independent samples of non parametric test,P<0.05 difference was statistically significant.In order to have no CMBs as the dependent variable,other risk factors as the independent variable,the single variable Logistic regression analysis,and then multivariable Logistic regression analysis,when P < 0.05 for the independent variables and the dependent variables are correlated.Result:1 This study included 156 cases of ischemic cerebrovascular disease,Large-artery atherosclerosis 90 cases(57.7%),Cardioembolism 12 cases(7.7 %),Small-artery occlusion Lacunar 16 cases(10.2 %),Transient ischemic attack38 cases(24.4%).Male 94 cases(60.3%),female 62 cases(39.7%).Select the patient's age range is 40 to 75 years old,the median age is roughly 58 years old.2 The general data of the patients were statistically analyzed,hypertension,high uric acid,high fibrinogen,total cholesterol and cerebral hemorrhage were positively correlated,and the difference was statistically significant(P<0.05).3 Cerebral microbleeds number of lesions were followed up for 6 months after observation,into the group of 156 cases,micro bleeding changes occurred in only 8 cases,3 cases patients the lesion increased 1 a(a(CMBS)in group B,2 a CMBS)(group A),1 case increased 2((CMBS)in group A)and l were increased by 4(CMBS(group B);among groups before treatment and cerebral microbleeds lesion number increase was not statistically significant.Conclusion:1 hypertension,high total cholesterol(TC),low density lipoprotein(LDL-C),high homocysteine(HcY)and CMBs were positively correlated with the risk factors,the low level of LDL-C and the occurrence of CMBs was not statistically significant.2 short term(six months)statin intensive lipid lowering therapy does not increase the risk of clinical cerebral hemorrhage in patients with ischemic stroke.