血清脂蛋白相关磷脂酶A2水平与急性缺血性脑卒中病情及预后的关系

doi:10.3969/j.issn.1004-583X.2023.04.004

摘要/Abstract

摘要：

目的研究血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipaseA2,Lp-PLA2)水平与急性缺血性脑卒中病情及预后的关系。方法从本院2021年4月21日-2022年4月21日接诊的人群中,选取49例体检健康者作为对照组,选取49例急性缺血性脑卒中患者作为观察组。入院时,采取酶联免疫吸附方法检测Lp-PLA2水平,采取NIHSS量表判断病情严重性。出院3个月,采取MRS量表对预后进行评估,研究Lp-PLA2水平与病情的关系,分析影响预后危险性因素。结果 (1)观察组饮酒史、吸烟史、疾病史和体重指数与对照组相比差异无统计学意义(P>0.05)。观察组Lp-PLA2水平显著高于对照组(P<0.05)。(2)在49例急性缺血性脑卒中患者中,轻度有19例,中度有16例,重度有14例,其Lp-PLA2水平和NIHSS评分差异有统计学意义(P<0.05)。(3)在49例急性缺血性脑卒中患者中,有35例预后良好,有14例预后不良。预后良好组和预后不良组在TOAST的分型方面差异无统计学意义(P>0.05)。预后良好组发病到住院的时间显著短于预后不良组,Lp-PLA2水平显著低于预后不良组(P<0.05)。(4)多因素 Logistic 回归分析结果表明,年龄和Lp-PLA2水平为影响急性缺血性脑卒中预后的主要因素(P<0.05)。结论在急性缺血性脑卒中患者中,Lp-PLA2水平越高,患者病情越严重,其是影响急性缺血性脑卒中预后危险性因素。

关键词: 缺血性卒中, 磷脂酶类A2, 预后

Abstract:

Objective To explore the correlation between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) level and the severity and prognosis of acute ischemic stroke (AIS). Methods From April 21, 2021 to April 21, 2022, forty-nine healthy volunteers receiving physical examination in our hospital were selected as the control group, and 49 patients with AIS were selected as the observation group. On admission, serum Lp-PLA2 level was detected by enzyme-linked immunosorbent assay (ELISA), and the severity of the disease was assessed by the National Institutes of Health Stroke Scale (NIHSS). Three months after discharge, the Modified Rankin Scale (mRS) was used to evaluate the prognosis, and the correlation between serum Lp-PLA2 level and the severity of disease was analyzed. Risk factors affecting the prognosis of AIS were identified. Results (1) There were no significant differences in drinking history, smoking history, disease history and body mass index (BMI) between the observation group and the control group (P>0.05). Serum Lp-PLA2 level in the observation group was significantly higher than that in the control group (P<0.05). (2) Among 49 patients with AIS, there were 19 mild cases, 16 moderate cases and 14 severe cases. There were significant differences in serum Lp-PLA2 levels and NIHSS score among them (P<0.05). (3) Among 49 patients with AIS, thirty-five patients had good prognosis and 14 had poor prognosis. There was no significant difference in the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification between patients with good prognosis and poor prognosis (P>0.05). Patients with good prognosis had a significantly shorter period from onset to hospitalization, and significantly lower serum Lp-PLA2 level than those with poor prognosis (both P<0.05). (4) Multivariable logistic regression analysis showed that age and serum Lp-PLA2 level were the main factors affecting the prognosis of AIS (P<0.05). Conclusion In patients with AIS, a high serum Lp-PLA2 level indicates a poor condition, which is a risk factor for the prognosis of AIS.

Key words: ischemic stroke, phospholipases A2, prognosis

中图分类号:

R743.3

贺翔渝, 潘燕, 张小林. 血清脂蛋白相关磷脂酶A2水平与急性缺血性脑卒中病情及预后的关系[J]. 临床荟萃, 2023, 38(4): 315-318.

He Xiangyu, Pan Yan, Zhang Xiaolin. Correlation between serum lipoprotein-associated phospholipase A2 level and the severity and prognosis of acute ischemic stroke[J]. Clinical Focus, 2023, 38(4): 315-318.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.04.004

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I4/315

图/表 4

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组别	例数	体重指数 ($\bar{x} \pm s$,kg/m²)	饮酒史 [例(%)]	吸烟史 [例(%)]	高血压 [例(%)]	疾病史[例(%)]		Lp-PLA2 ($\bar{x} \pm s$,μg/L)
组别	例数	体重指数 ($\bar{x} \pm s$,kg/m²)	饮酒史 [例(%)]	吸烟史 [例(%)]	高血压 [例(%)]	糖尿病	冠心病	Lp-PLA2 ($\bar{x} \pm s$,μg/L)
对照组	49	27.18±2.23	14(28.57)	22(44.90)	11(22.45)	13(26.53)	14(28.57)	425.73±158.31
观察组	49	27.62±2.47	15(30.61)	21(42.86)	10(20.41)	12(24.49)	15(30.61)	190.35±69.26
t/χ²值		1.121	0.123	0.214	0.139	0.901	0.101	12.53
P值		0.123	0.714	0.735	0.812	0.178	0.217	<0.01

组别	例数	体重指数 ($\bar{x} \pm s$,kg/m²)	饮酒史 [例(%)]	吸烟史 [例(%)]	高血压 [例(%)]	疾病史[例(%)]		Lp-PLA2 ($\bar{x} \pm s$,μg/L)
组别	例数	体重指数 ($\bar{x} \pm s$,kg/m²)	饮酒史 [例(%)]	吸烟史 [例(%)]	高血压 [例(%)]	糖尿病	冠心病	Lp-PLA2 ($\bar{x} \pm s$,μg/L)
对照组	49	27.18±2.23	14(28.57)	22(44.90)	11(22.45)	13(26.53)	14(28.57)	425.73±158.31
观察组	49	27.62±2.47	15(30.61)	21(42.86)	10(20.41)	12(24.49)	15(30.61)	190.35±69.26
t/χ²值		1.121	0.123	0.214	0.139	0.901	0.101	12.53
P值		0.123	0.714	0.735	0.812	0.178	0.217	<0.01

病情程度	例数	Lp-PLA2水平 ($\bar{x} \pm s$,μg/L)	NIHSS ($\bar{x} \pm s$,分)
轻度	19	310.47±90.68	4.93±1.40
中度	16	412.87±122.14	9.65±1.48
重度	14	582.08±143.20	16.89±1.52
F值		23.015	2.146
P值		0.000	0.000

病情程度	例数	Lp-PLA2水平 ($\bar{x} \pm s$,μg/L)	NIHSS ($\bar{x} \pm s$,分)
轻度	19	310.47±90.68	4.93±1.40
中度	16	412.87±122.14	9.65±1.48
重度	14	582.08±143.20	16.89±1.52
F值		23.015	2.146
P值		0.000	0.000

组别	例数	发病到住院的时间 ($\bar{x} \pm s$,h)	TOAST的分型[例(%)]					Lp-PLA2 ($\bar{x} \pm s$,μg/L)
组别	例数	发病到住院的时间 ($\bar{x} \pm s$,h)	CE	SAA	LAA	SUE	SOE	Lp-PLA2 ($\bar{x} \pm s$,μg/L)
预后良好	35	4.83±2.29	7(20.00)	11(31.43)	10(28.57)	3(8.57)	4(11.43)	346.27±104.51
预后不良	14	7.76±2.83	3(21.43)	4(28.57)	4(28.57)	1(7.14)	2(14.29)	589.76±152.32
t/χ²值		2.870	0.010	0.03	0.384	1.436	0.452	11.561
P值		0.004	0.822	0.786	0.384	0.311	0.539	<0.001