Correlation between serum lipoprotein-associated phospholipase A2 level and the severity and prognosis of acute ischemic stroke

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

Abstract

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

CLC Number:

R743.3

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.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.04.004

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

Figures/Tables 4

References 20

[1]	Jolugbo P, Ariëns RAS. Thrombus composition and efficacy of thrombolysis and thrombectomy in acute ischemic stroke[J]. Stroke, 2021, 52(3):1131-1142. doi: 10.1161/STROKEAHA.120.032810 pmid: 33563020
[2]	朱子煜, 王磊, 王祖华, 等. 血清Lp-PLA2、PARK7、EPO水平变化与急性缺血性脑卒中患者NIHSS评分、CIMT的关系[J]. 中国医师杂志, 2020, 22(8):1204-1207.
[3]	李绍持. 急性缺血性脑卒中患者脂蛋白相关磷脂酶A2和同型半胱氨酸水平的变化分析[J]. 蛇志, 2020, 32(2):161-163.
[4]	白如玉, 郭晓贤, 郝美美, 等. 阿加曲班联合乌司他丁对急性缺血性脑卒中病人血清Lp-PLA2和ADAMTS-1水平的影响[J]. 实用老年医学, 2020, 34(5):434-438.
[5]	Li J, Cao T, Wei Y, et al. A review of novel cardiac biomarkers in acute or chronic cardiovascular diseases: The role of soluble ST2 (sST2), lipoprotein-associated phospholipase A2 (Lp-PLA2), myeloperoxidase (MPO), and procalcitonin (PCT)[J]. Dis Markers, 2021:6258865.
[6]	杨远芳, 滕跃华. 血清Lp-PLA2、RDW水平与老年急性缺血性脑卒中患者静脉溶栓后早期神经功能恶化的相关性[J]. 临床与病理杂志, 2022, 42(8):1930-1936.
[7]	Mendelson SJ, Prabhakaran S. Diagnosis and management of transient ischemic attack and acute ischemic stroke: A review[J]. JAMA, 2021, 325(11):1088-1098. doi: 10.1001/jama.2020.26867 pmid: 33724327
[8]	邓余杰, 范林清, 张涛. 脂蛋白相关磷脂酶A2与中老年高血压患者颈动脉不稳定斑块的关系[J]. 临床荟萃, 2021, 36(2):112-116.
[9]	刘晓腾, 单伟超, 侯瑞田, 等. 血清超敏C反应蛋白、脂蛋白相关性磷脂酶A2与老年原发性高血压合并2型糖尿病的相关性[J]. 临床荟萃, 2021, 36(1):25-29.
[10]	朴清花, 刘秋庭. 脂蛋白相关磷脂酶A2与急性缺血性脑卒中复发的相关性研究[J]. 临床医学研究与实践, 2021, 6(22):11-13+21.
[11]	李雪峰, 王清芳, 冯玉凤. Lp-PLA2、Annexin A2与溶栓后急性缺血性脑卒中患者预后的相关性[J]. 承德医学院学报, 2021, 38(4):301-306.
[12]	郝羽. 醒脑静注射液联合依达拉奉对急性缺血性脑卒中患者血清脂蛋白相关磷脂酶A2和促红细胞生成素的影响[J]. 中国民间疗法, 2021, 29(9):88-91.
[13]	李岚欣, 李波, 何强华, 等. 血清脂蛋白相关磷脂酶A_2、缺血修饰蛋白及血小板活化因子对缺血性脑卒中病情程度及预后的评估价值[J]. 中西医结合心脑血管病杂志, 2020, 18(23):4061-4064.
[14]	杨保华, 付胜, 伏冬梅. 舒血宁注射液联合重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中疗效及对血清脂蛋白相关磷脂酶A2、同型半胱氨酸、高敏C反应蛋白水平的影响[J]. 实用医院临床杂志, 2020, 17(6):79-82.
[15]	曹莉梅, 蒋宾, 廖远高. 血清脂蛋白相关磷脂酶A2水平与急性缺血性脑卒中患者病情及预后的关系[J]. 中风与神经疾病杂志, 2020, 37(10):877-880.
[16]	Lv SL, Zeng ZF, Gan WQ, et al. Lp-PLA2 inhibition prevents Ang II-induced cardiac inflammation and fibrosis by blocking macrophage NLRP3 inflammasome activation[J]. Acta Pharmacol Sin, 2021, 42(12):2016-2032. doi: 10.1038/s41401-021-00703-7 pmid: 34226664
[17]	付增源. 血清Lp-PLA2、PLR水平变化与缺血性脑卒中患者NIHSS评分的相关性及临床意义[J]. 医学检验与临床, 2022, 33(4):48-51.
[18]	宋雪云, 王少伟, 吴胜峰, 等. 癫狂梦醒汤联合辛伐他汀治疗大动脉粥样硬化型缺血性脑卒中恢复期(风痰阻络证)的临床疗效及其对患者神经功能的影响[J]. 实用心脑肺血管病杂志, 2022, 30(3):89-93, 102.
[19]	单娜, 赵丽, 林晓东. 首发急性缺血性脑卒中患者认知障碍发生的危险因素及对Lp-PLA2、sCD40 L的相关性研究[J]. 川北医学院学报, 2022, 37(6):754-758.
[20]	李一璐, 周亚军, 任晨曦, 等. 急性缺血性脑卒中患者血清RBP4、Lp-PLA2及MCP-1水平表达及其与患者病情及预后的关系研究[J]. 现代生物医学进展, 2022, 22(11):2086-2090, 2027.

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