| Objective:To investigate the changes of lysophosphatidic acid(LPA),cystatin-c(CysC)levels in patients with acute ischemic stroke,and the relationship between lysophosphatidic acid,cystatin-c levels and the A-S-C-O subtypes of acute ischemic stroke.Methods:According to the continuity of inclusion and exclusion criteria,197 cases of acute ischemic stroke patients in the neurology department of Weihai Central Hospital were collected as case groups from January 2015 to May 2017,the cases of control group were 100 healthy people at the period time.Measure lysophosphatidic acid and cystatin-c levels.The patients' histories of sex,age,smoking,drinking,hypertension,diabetes,myocardial infarction,coronary revascularization,peripheral arterial disease,family history of cerebrovascular disease and so on were collected.The results of fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,creatinine and uric acid were measured.Take the examination of brain MRI(FLAIR and DWI),brain and neck MRA or DSA,TCD,artery ultrasound of carotid and vertebral;routine twelve lead ECG,dynamic electrocardiogram,echocardiography;hematologic tests(platelet,leucocytes,and eosinophilic counts,hematocrit),blood coagulation,inflammatory markers(erythrocyte sedimentation rate,C-reactive protein),homocysteine and other examination.All the patients were classified strictly according to the A-S-C-O phenotypicclassification of acute ischemic stroke: A for atherosclerosis,S for small vessel disease,C for cardiac source,O for other cause.Each of the 4 phenotypes is graded 1,2,or 3.1 or ‘definitely a potential cause of the index stroke',2 for ‘causality uncertain',3for‘unlikely a direct cause of the index stroke(but disease is present)'.When the disease is completely absent,the grade is 0;when grading is not possible due to insufficient workup,the grade is 9.The proportion of A-S-C-O classification was analyzed.Compare with the lysophosphatidic acid,cystatin-c levels of the acute ischemic stroke group and control group;each etiological group of acute ischemic stroke and control group;the various etiological groups of acute ischemic stroke.The risk factors for acute ischemic stroke of ASCO-A1 phenotypic group were analyzed by logistic regression.Results:?In all 197 cases of patients with acute ischemic stroke,Application of AS-C-O grade 1 indicated evidence,A1 was the highest(38.07%),the next was S1(31.47%),C1(15.74%),and O1(2.54%).?LPA and Cys-C levels of the patients with acute ischemic stroke were significantly higher than those of the control group(P<0.001).? LPA and Cys-C levels of ASCO-A1,ASCO-S1 and ASCO-C1 were significantlyhigher than those of control group(P< 0.001),cases of the ASCO-O1 group were too less to analyse;The LPA level of the ASCO-C1 group was significantly higher than that of ASCO-A1(P=0.005)and ASCO-S1 group(P< 0.001),and there was no significant difference between ASCO-S1 and ASCO-A1 in the LPA level(P>0.05);the Cys-C level of the ASCO-C1 group was significantly higher than that of ASCO-S1 group(P=0.003),and there was no significant difference between ASCO-A1 and ASCO-C1 in the Cys-C level(P>0.05),and there was no significant difference between ASCO-A1 and ASCO-S1 in the Cys-C level(P>0.05).? The LPA level of A1+2-S0-C0+3-O0 and A0-S1+2-C0+3-O0 was significantly higher than that of control group(P<0.001).The Cys-C level of A1+2-S0-C0+3-O0(P<0.001)and A0-S1+2-C0+3-O0(P=0.005)was significantly higher than that of control group,cases of the A0-S0-C1-O0 and A0-S0-C0-O1 group were too less to analyse;LPA(P<0.001)and Cys-C(P=0.014)levels of A1+2-S0-C0+3-O0 group were significantly higher than those of A0-S1+2-C0+3-O0 group.? The logistic regression analysis indicated that lysophosphatidic acid(OR=5.275,95%CI2.145-12.364P=0.001)and Cys-C levels(OR=4.826,95% CI 1.935-10.386,P = 0.001)were independentrisk factors of phenotypic group ASCO A1 subtype in acute ischemic stroke.Conclusions:LPA,Cys-C levels of patients with acute ischemic stroke were significantly higher than those of the control group;There were differences in LPA,Cys-C levels of patients with different subtypes of A-S-C-O classification,the LPA level of the ASCO-C1 group was significantly higher than those of ASCO-A1 and ASCO-S1 group,the Cys-C level of the ASCO-C1 group was significantly higher than that of ASCO-S1 group.LPA and Cys-C levels of A1+2-S0-C0+3-O0 group were significantly higher than those of A0-S1+2-C0+3-O0 group.LPA and Cystatin C are independentrisk factors for the atherosclerotic phenotype group ASCO A1 in patients with acute ischemic stroke. |
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