Relationship Between Serum Oxidized Low-density Lipoprotein Level and Carotid Vulnerable Plaque in Patients with Acute Cerebral Ischemic Stroke / 中国医学影像学杂志

PurposeTo investigate the relationship between the serum oxidized low-density lipoprotein (ox-LDL) level and carotid vulnerable plaque in patients with acute cerebral ischemic stroke, and to evaluate the ability of serum ox-LDL in identifying vulnerable carotid plaques.Materials and Methods 181 patients with history of acute cerebral ischemic stroke were recruited. According to the results of carotid ultrasound patients were divided into non plaque group (n=48), stable plaque group (n=38) and vulnerable plaque group (n=95). The serum total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting plasma glucose and ox-LDL were measured. Carotid intima-medial thickness (CIMT), total carotid plaque area (TPA) and the characters of plaque were examined with color Doppler ultrasound.Results The serum ox-LDL and the number of patients with hypertension in plaque group were significantly higher than that in the non-plaque group (P<0.05). The serum ox-LDL and TPA in the vulnerable plaque group were significantly higher than that in the stable plaque group (P<0.05). Serum ox-LDL in patients with acute cerebral infarction was positively correlated with CIMT, serum total cholesterol and LDL-C (r1=0.154,P<0.05;r2=0.338, P<0.05;r3=0.385,P<0.05). Logistic regression analysis showed that serum ox-LDL was an independent risk factor for carotid vulnerable plaque (OR=1.038, 95%CI 1.008-1.069, P<0.01).Conclusion The serum ox-LDL is independently associated with the formation of vulnerable plaque in patients with acute cerebral infarction. This study suggests that ox-LDL can be used as a biomarker in screening for vulnerable carotid plaque in clinical practice. Carotid ultrasound combined with serology can early identify carotid artery vulnerable plaque that may lead to cerebral ischemic events.

Intravenous thrombolysis in acute cerebral infarction with cerebral microbleeds / 实用医学杂志

Objective To investigate the influence of intravenous thrombolysis to acute cerebral infarction with cerebral microbleeds (CMB). Methods Eight-nine patients with cerebral infarction in the Neurological Department of the Second Affiliated Hospital of Guangzhou Medical College from January 1st , 2011 to December 31st, 2012 were enrolled in this study. All patients were scanned with MRI and GRE. According to the presence of CMB, the patients were classified into two groups, including CMB group and non-CMB group. Past history of smoking, drinking, hypertension, lacunar infarction, diabetes and leukoaraiosis situation were recorded and risk factors of CMB were explored. All patients were treated with intravenous thrombolysis and rescanned with MRI to compare the total number of CMB 24 hours after thrombolysis. Results In the CMB group, the number of patients with mild CMB decreased and the number of patients with serious CMB increased after thrombolysis. CMB was associated with sex, age, hypertension, lacunar infarction and leukoaraiosis. Conclusions Sex, age, hypertension, lacunar infarction and leukoaraiosis were the risk factors of CMB in acute cerebral infarction. Thrombolysis in acute cerebral infarction augments the incidence of CMB and promotes the hemorrhagic transformation.