Relationship Between Apolipoprotein B/A1,Glycosylated Hemoglobin Level And Outcome In Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis

Objective:To investigate the relationship between apolipoprotein B/A1(apoB/A1),glycated hemoglobin(HbA1c)level and outcome in Acute Ischemic Stroke(AIS)patients treated with intravenous thrombolysis,and to explore the mechanism.Methods:A total of 129 patients with acute ischemic stroke who underwent rt-PA intravenous thrombolysis in the Department of Neurology,Affiliated Hospital of Chengde Medical University from September 2016 to September 2018 was continuously collected,and recorded their clinical data.And according to The National Institutes of Health Stroke Scale(NIHSS),the all enrolled patients were scored at admission.Then they were scored by the modified Rankin scale(mRS)at 3 months after discharge.They were divided into a good prognosis group(mRS ? 2 points,95 cases)and a poor prognosis group(mRS > 2 points,34 cases).According to whether the patients had early neurological deterioration(END),they were divided into the END group(8 cases)and the END group(121 cases),and the differences between the groups were compared.All the datas were analyzed by SPSS19.0 statistical software.And the multivariate logistic regression was used to analyze the factors affecting the intravenous thrombolysis outcome of AIS.Results:1 Univariate analysis of general data of different prognostic groups in AIS thrombolysisThere were no significant differences in gender,age,smoking,drinking,coronary heart disease history,atrial fibrillation history,TG,TC,GLU,LDL-C,HDL-C,Cr,BUN,UA between the two groups(P>0.05).There were significant differences in HbA1 c,apoB/A1,admission NIHSS score,history of hypertension,and history of diabetes(P<0.05).Compared with the data between the two groups,the NIHSS score,HbA1 c,and apoB/A1 levels were all prognosis.The adverse group was significantly higher than the good group.In hypertension and diabetes,the prognosis rate of the disease was higher than that of the disease.So,there were significant differences in different prognostic groups in HbA1 c,apoB/A1,admission NIHSS score,history of hypertension,history of diabetes.These indicators were suspected factors influencing the prognosis of AIS thrombolysis.2 Comparison of general data between END group and no END group after thrombolysisThere were no significant differences between the two groups in gender,smoking history,drinking,coronary heart disease history,atrial fibrillation history,TG,TC,GLU,LDL-C,HDL-C,Cr,BUN,UA(P>0.05);While there were significant differences in the history of diabetes,age,history of hypertension,NIHSS score,HbA1 c,and apoB/A1(P<0.05);and in the END group,the age,history of hypertension,history of diabetes,HbA1 c,apoB/A1,and NIHSS is higher than the no END group.So in the END group,the age,HbA1 c,apoB/A1,NIHSS,history of hypertension,history of diabetes was higher than the no END group.These indicators were suspected influencing factors of END.3 Spearman correlation analysis showed that HbA1 c was positively correlated with poor prognosis and END of AIS thrombolysis(r = 0.361,P < 0.05;r = 0.297,P< 0.05),and apoB/A1 was positively correlated with poor prognosis and END of AIS thrombolysis(r = 0.284,P < 0.05;r = 0.303,P < 0.05).4 Logistic regression analysis of influencing factors of AIS thrombolysis outcomeFor different prognostic groups,the results of multivariate logistic regression analysis showed that the NIHSS score at admission(OR=1.509),95% CI=1.26~1.808,P<0.05),HbA1c(OR=1.273,95% CI=1.069~1.515,P<0.05),apoB/A1(OR=1.021,95%CI=1.004~1.038,P <0.05)levels were independent risk factors for the prognosis of thrombolysis.For the END group after thrombolysis,the results of multivariate logistic regression analysis showed that HbA1c(OR= 1.657,95% CI=1.078~2.549,P<0.05),apoB/A1(OR=1.023,95% CI=1.003~1.043,P<0.05)were independent risk factors for END in patients with AIS intravenous thrombolysis.Conclusions:Admission NIHSS score,HbA1 c,apoB/A1 were independent risk factors for the prognosis of patients with rt-PA intravenous thrombolysis;HbA1c,apoB/A1 were independent risk factors for early neurological deterioration in patients with intravenous thrombolysis;high levels of HbA1 c,apoB/A indicates a poor endometrial thrombolysis outcome.