脂蛋白(a)水平与急性脑梗死患者脑微出血的相关性研究OA

Objective To explore the correlations between lipoprotein(a)[LP(a)]levels and the characteristics of cerebral microbleeds(CMBs)in patients with acute cerebral infarction(ACI),and to provide a basis for clinical evaluation of the risk of cerebral small vessel injury.Methods A retrospective study was conducted on 258 ACI patients admitted to the De-partment of Neurology,Anting Hospital of Jiading District,Shanghai between March 2023 and May 2024.According to the re-sults of cranial magnetic resonance susceptibility-weighted imaging,the patients were divided into the CMB group(90 cases)and the non-CMB group(168 cases).Demographic data,underlying disease history,lifestyle,and blood lipid-related labora-tory indicators of the two groups were collected,and the differences in indicators between the groups were compared.Multivari-ate logistic regression analysis was used to identify the independent risk factors for CMB in ACI patients.The correlations be-tween blood lipid indicators such as LP(a)and the number and location of CMB were further analyzed.Results Age,the pro-portions of patients with hypertension,diabetes,and smoking history,and LP(a)level in the CMB group were significantly higher than those in the non-CMB group,while the level of high-density lipoprotein cholesterol(HDL-C)was significantly lower(P<0.05).There were no significant differences in total cholesterol,triglycerides,and low-density lipoprotein cholesterol be-tween the two groups(P>0.05).Multivariate logistic regression analysis showed that advanced age,history of hypertension,hypo-HDL-cholesterolemia,and hyperlipoproteinemia(a)were independent risk factors for CMB in ACI patients.Correlation analysis suggested that the number of CMB was positively correlated with LP(a)and negatively correlated with HDL-C.LP(a)levels were higher and HDL-C levels were lower in patients with deep/infratentorial CMB than in patients with lobar CMB(P<0.05).Conclusion Hyperlipoproteinemia(a)and hypo-HDL-cholesterolemia are closely related to the occurrence of CMB in ACI patients,and may be related to the number and location of CMB.Clinically,it is necessary to focus on monitoring the levels of LP(a)and HDL-C in ACI pa-tients for early prevention and control of cerebral small vessel disease and the risk of microbleeds.