脂蛋白相关磷脂酶A2和同型半胱氨酸水平与青年缺血性卒中相关性

The correlation between lipoprotein-associated phospholipase A2 and homocysteine levels with ischemic stroke in youth

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)水平与青年缺血性卒中的相关性。方法选取2020年4月-2021年6月收治于甘肃武威医学科学研究院的60例青年缺血性卒中患者为观察组,另选取54名健康人群为对照组。比较两组血清Lp-PLA2、Hcy水平;对比2种指标单独及联合应用对青年缺血性卒中的诊断效能;分析2种指标和美国国立卫生研究院卒中量表(NIHSS)、日常生活活动能力量表(ADL)之间的相关性。结果观察组血清Lp-PLA2、Hcy水平均显著高于对照组,差异有统计学意义(t=18.994、12.093,P<0.05);2种指标联合应用诊断青年缺血性卒中的敏感度为83.84%、特异度为89.87%,均高于单独应用。观察组治疗后血清LpPLA2、Hcy水平均显著低于治疗前,差异有统计学意义(t=13.029、10.715,P均<0.05);治疗后NIHSS、ADL评分均优于治疗前(t=29.830、12.783,P均<0.05);相关性分析表明,血清Lp-PLA2、Hcy水平与NIHSS评分呈正相关,与ADL评分呈负相关(P均<0.05)。结论青年缺血性卒中患者血清Lp-PLA2、Hcy水平偏高,且与NIHSS、ADL评分有相关性,两者联合应用可提高诊断效能。

Objective To investigate the correlation between lipoprotein-related phospholipase A2(Lp-PLA2),homocysteine(Hcy)levels and ischemic stroke in young people.MethodsA total of 60 young patients with ischemic stroke admitted to Gansu Wuwei Academy of Medical Sciences from April 2020 to June 2021 were selected as the observation group,and 54 healthy people were selected as the control group.The levels of serum Lp-PLA2 and Hcy between the two groups were compared.The diagnostic efficacies of the two indicators alone and in combination for ischemic stroke in young adults were compared.The correlation between the two indexes and National Institute of Health Stroke Scale(NIHSS)and activity of daily living(ADL)was analyzed.ResultsThe serum levels of Lp-PLA2 and Hcy in the observation group were significantly higher than those in the control group(t=18.994,12.093,all P<0.05);the combined application of the two indicators in the diagnosis of ischemic stroke in young adults had a sensitivity of 83.84%and a specificity of 89.87%that were higher than those of the individual application.Serum Lp-PLA2 and Hcy levels in the observation group after treatment were significantly lower than those of before treatment(t=13.029,10.715,all P<0.05).NIHSS and ADL scores after treatment were better than those of before treatment(t=29.830,12.783,all P<0.05).Correlation analysis showed that serum Lp-PLA2 and Hcy levels were positively correlated with NIHSS score and negatively correlated with ADL scores(all P<0.05).ConclusionsSerum Lp-PLA2 and Hcy levels were high in young patients with ischemic stroke.The combined application of the two could improve the diagnostic efficiency,and they were correlated with NIHSS and ADL scores.