缺血性脑卒中患者血清氧化脂蛋白(a)水平升高

Increased serum levels of oxidized lipoprotein( a) in patients with cerebral ischemic stroke

目的观察血清氧化脂蛋白（a）[ox-Lp（a）]水平及其与缺血性脑卒中（CIS）严重程度间的关系。方法分别检测93例CIS患者[按美国国立卫生研究院卒中量表（NIHS）评分分为轻型48例，重型45例]，脑出血患者30例和体检健康者48例血清ox—Lp（a）、Lp（a）水平并进行统计学分析。结果CIS轻型、重型患者血清ox—Lp（a）（t分别为-2．147、-5．082，P均〈0．05）、Lp（a）（t分别为-2．347、-4．187，P均〈0．05）水平均高于体检健康者，CIS重型患者血清ox-Lp（a）、Lp（a）水平均高于轻型组（t分别为-2．700、-0．231，P均〈0．05）和脑出血组（t分别为4．205、-2．180，P均〈0．05）。CIS患者血清ox-Lp（a）与Lp（a）水平呈正相关（r=0．429，P〈0．01），与HDL-C水平呈负相关（r=-0．149，P〈0．01）；NIHSS与血清ox—Lp（a）、Lp（a）水平呈正相关（r分别为0．324、0．299，P均〈0．01）。多元线性回归分析显示血清ox-Lp（a）、Lp（a）共同决定了13．6％的NIHSS变化[β分别为0．246、0．243，P均〈0．05；决定系数（R^2）=0．136）]。多元Logistic回归分析显示，校正年龄、性别和血脂水平等因素后，高ox—Lp（a）水平是CIS重型组的危险因素[风险比（OR）=1．209，95％可信区间（CI）=1．033—1．414]。结论CIS患者血清ox-Lp（a）水平升高，并与疾病严重程度相关。

Objective To investigate the relationship between serum levels of oxidized lipoprotein （a） [ ox-Lp（a） ] and the severity of cerebral ischemic stroke （CIS）. Methods Serum samples were collected from 93 CIS patients, including 45 severe CIS and 48 mild CIS, 30 patients with cerebral hemorrhage and 48 healthy controls. Then, the ox-Lp（a） and lipoprotein （a） [ Lp（a） ] levels in serum were measured and compared. Results Both serum ox-Lp （a） and Lp （a） levels in the severe and mild CIS patients were significantly higher than those in healthy controls （ all P 〈 0.05 ）. The serum levels of ox-Lp（a） and Lp（a） in the severe CIS patients were significantly higher than those in the mild CIS patients and the patients with cerebral hemorrhage （ all P 〈 0.05 ）. The serum ox-Lp（a） levels were positively correlated with Lp（a） levels （ r = 0. 429, P 〈 0.01 ）, and negatively with HDL-C levels （ r = - 0. 149, P 〈 0.01 ） in CIS patients. The National Institutes of Health Stroke Scale （NIHSS） scores in CIS patients were positively correlated with ox-Lp（a） （ r = 0.324, P 〈 0.01 ） and Lp （a） levels （ r = 0. 299, P 〈 0.01 ）. The multiple linear regression analysis showed that both ox-Lp （a） （β =0. 246, P =0. 031 ） and Lp（a） （β =0.243, P = 0. 033） accounted for 13.6% of the variation in NIHSS （R^2 = 0. 136）. The multiple logistic regression analysis showed that serum ox-Lp（a） was the potential risk factor of severe CIS after adjusting for age, sex and plasma lipid levels （ OR = 1. 209, 95% CI = 1. 033 - 1. 414）. Conclusion There were increased serum ox-Lp（a） levels in CIS patients, which was related to the severity of CIS.