| Objective: In recent years,Lp（a）has become a research hotspot of cardiovascular diseases.Lp（a）promotes the progression of AS through various ways such AS promoting AS,promoting thrombosis and promoting inflammation,and eventually causes cardiovascular and cerebrovascular diseases.There are relatively few reports about Lp（a）and cerebrovascular diseases.The study of risk factors related to carotid artery unstable plaque is a medical hotspot.In this paper,we studied the level of lipoprotein（a）[Lp（a）] in venous blood of patients with acute ischemic stroke（AIS）with carotid artery unstable plaque and AIS with carotid artery stable plaque.To investigate the relationship between Lp（a）level and carotid plaque instability（vulnerability）and AIS,and to provide theoretical basis for early clinical intervention of Lp（a）.Methods: Retrospective selection for September 2020 to February 2021,in Dali university first affiliated hospital neurology hospital diagnosed with AIS and complete clinical data of diagnosis and treatment of 70 cases（41 patients with male,the female patients with 29 cases）,by carotid artery colour to exceed examination diagnosed with unstable carotid plaques 32 cases（of unstable plaque group）,38 cases of carotid artery stable plaque（stable plaque group）.Collect general information on all selected candidates,including name,sex,age,ethnicity,smoking history,alcohol consumption history,hypertension,diabetes,and BMI.Fasting venous blood samples were collected in the morning of the second day after admission for blood lipids including total cholesterol（TC）,triglyceride（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,apolipoprotein A1（APOA1）,apolipoprotein B（APO-B）and Lp（a）.SPSS 25.0 statistical software was used for statistical analysis of all the collected data,and the test level was set as 0.05.If P < 0.05,the difference was considered statistically significant.Results:1.Lp（a）and APOA1 in stable plaque group and unstable plaque group were statistically significant between the two groups（P < 0.05）.Multivariate Logistic regression analysis showed that serum Lp（a）was independently positively correlated with the occurrence of carotid plaque（β > 0）,suggesting that Lp（a）was an independent risk factor for carotid plaque.2.The Lp（a）level in the unstable plaque group was higher than that in the stable plaque group.In the range of Lp（a）> 30mg/ d L,20 cases（28.6%）in the unstable plaque group were significantly higher than that in the stable plaque group 7 cases（10%）.3.Lp（a）/APOA1 ratio of stable plaque group and unstable plaque group was statistically significant between the two groups（P < 0.01）.Multivariate Logistic regression analysis showed that serum Lp（a）/APOA1 ratio was independently positively correlated with the occurrence of carotid artery unstable plaque（β > 0）,suggesting that Lp（a）/APOA1 ratio was an independent risk factor for carotid artery unstable plaque.4.ROC curve was used to analyze the predictive value of serum Lp（a）and Lp（a）/APOA1 ratio for carotid plaque instability in AIS patients,and the results showed that the area under curve of serum Lp（a）in predicting carotid plaque instability was0.717（95%CI: 0.595-0.838,P < 0.001）,Lp（a）/APOA1 ratio was 0.727（95%CI:0.606-0.847,P < 0.01）;It is suggested that serum Lp（a）and Lp（a）/APOA1 ratio have certain predictive value for unstable carotid plaque.5.Rank correlation analysis was used to analyze the severity of Lp（a）and AIS patients（NIHSS score was used）,and there was no statistical significance between Lp（a）and AIS patients（P > 0.05）.Conclusion:1.Lp（a）is an independent risk factor for unstable carotid plaque.2.When Lp（a）> 30 mg/ d L,the risk of carotid plaque instability began to increase.3.Lp（a）/APOA1 ratio was an independent risk factor for carotid unstable plaque,suggesting that Lp（a）/APOA1 ratio was closely related to carotid unstable plaque.4.Lp（a）and Lp（a）/APOA1 ratio have certain predictive value for carotid unstable plaque.5.There is no correlation between Lp（a）level and severity of AIS patients. |
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