Study On The Correlation Between Serum PCSK9 With Cerebral Arterial Atherosclerosis And The Lipid-lowering Effect Of Statin In Patients With Cerebral Infarction

Objective:To investigate the relationship between serum PCSK9 levels with the severity of cerebral arterial atherosclerosis and multiple risk factors of atherosclerosis in atherosclerotic cerebral infarction patient,and to explore the relationship between serum PCSK9 level and the lipid-lowering effect of oral statin therapy in this population.Method:Selected the atherosclerotic cerebral infarction subjects who accepted CA and TCD examination in the department of Neurology of Jilin University First Hospital from December 2015 to December2016.Collect fasting biood samples and record the history and biochemical information including age,sex,hypertension,diabetes,hyperlipidemia,previous medication history,smoking,drinking,family history,lipids,fasting blood glucose,folic acid,vitamin B12,uric acid,homocysteine,etc.The data of CA and TCD were recorded and divided into different group according to the degree of AS lesion.Grouped as follows: no plaque group,plaque group(visible presence of carotid plaques in CA,but no stenosis of blood vessels),mild stenosis group(the rate of stenosis<50%),moderate stenosis(the rate of stenosis is 50% to69%),severe stenosis(the rate of stenosis is 70% to 99%)or occlusion group(CA and TCD could't detect the blood flow signal of the related artery).The level of serum PCSK9 was detected by ELISA.For patients who need statin therapy,we assessed the changes in blood lipid metabolism after treatment with statins by follow-up study.Statistical analysis was used to analyze the correlation between serum PCSK9 level and cerebral arterial atherosclerosis,risk factors of atherosclerosis and the lipidlowering effect of oral statins.Result:1.The median serum PCSK9 level in this study was 130.76 ng / ml,the 25 th percentile was 105.71 ng / ml and the 75 th percentile was 157.54 ng / ml.There was a statistically significant difference between female and male serum PCSK9(P <0.05),and the level of female PCSK9 was slightly higher than male.2.serum PCSK9 levels were positively correlated with the degree of cerebral atherosclerosis(P <0.01).3.serum PCSK9 levels were positively correlated with SBP,FBG,TG,LDL-C,and statistically significant(P <0.05).The results showed that the level of serum PCSK9 was more closely related to the three risk factors of TG,LDL-C and TC by multiple stepwise regression analysis.4.By short-term(one month)statin therapy,serum TC,TG,LDL-C decreased compared with before treatment,HDL-C increased before treatment(P <0.01).There was no significant correlation between serum PCSK9 and the decrease of lipid components.Conciusions:1.Female PCSK9 levels are higher than men.2.Serum PCSK9 levels were positively correlated with the degree of cerebral atherosclerosis and a number of risk factors.3.There was no significant correlation between serum PCSK9 level and statin lipid-lowering effect.