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及影响因素

Variation and influencing factors of Lp-PLA2 and HCY levels in acute ischemic stroke patients

目的研究急性缺血性脑卒中患者血脂蛋白相关磷脂酶A2（Lp-PLA2）、同型半胱氨酸（HCY）水平的变化及影响因素。方法将192例符合筛选标准的急性缺血性脑卒中患者设为卒中组，79例健康体检者设为对照组，前者又根据美国国立卫生院卒中量表（NIHSS）评价神经功能缺损程度，分为轻度（＜4分）、中度（4-15分）和重度（＞15分）三个组；采血检测血浆Lp-PLA2水平、血清HCY水平、血常规和血生化。结果①脑卒中组Lp-PLA2、HCY水平显著高于对照组，而且重度组高于中度组，中度组高于轻度组，差异均有统计学意义（P＜0．05）；②脑卒中组血白细胞（WBC）、中性粒细胞（NE）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、脂蛋白a[Lp（a）]、葡萄糖（Glu）水平显著高于对照组；高密度脂蛋白（HDL）低于对照组（P＜0.05）；③多重线性回归分析显示，Lp-PLA2与年龄、肥胖、NIHSS评分、HCY呈正相关，HCY与性别、吸烟、NIHSS评分、LP（a）呈正相关。结论急性缺血性脑卒中血Lp-PLA2和HCY水平均增高，两者显著相关，联合检测可为临床的治疗和二级预防提供一定的帮助。

Objective To investigate the variation and influence factors of plasma lipoprotein-associated phospholipase A2 （ Lp-PLA2 ） and homocysteine （ HCY） in the patients with acute ischemic cerebral stroke.Methods One hundred and ninety-two cases with acute ischemic cerebral stroke as stroke group, according to National Institutes of Health Stroke Scale, were divided into mild group （ n=16）, moderate group （n=163）, and severe group （n=13）.Seventy-nine cases of healthy donors were selected at the same time as control.Enzyme -linked immunosorbent assay （ ELISA ） was performed to detect plasma Lp-PLA2 , chemiluminescence was carried out for plasma HCY, besides we detect the white blood cells （ WBC ） , neutrophil （ NE ） and blood biochemical analysis.Results （1） Plasma levels of Lp -PLA2 and HCY of stroke group were significantly higher than those of the control group, and severe group were higher than the moderate group which were higher than the mild group, the differences were all statistically significant （P〈0.05）.（2） Stroke group showed markedly higher white blood cells （ WBC） , neutrophil （ NE） , cholesterol （ TC） , triglyceride （ TG） , low density lipoprotein （ LDL） , lipoprotein Lp （ a） and glucose （ Glu） levels compared with the control group, the difference was statistically significant （ P〈0.05 ）; high density lipoprotein （ HDL） was lower in the stroke group than that of the control group, the difference was statistically significant （P 〈0.05）. （3） Multiple linear regression analysis showed that ①Lp -PLA2 was positively correlated with age, obesity, NIHSS, HCY, had no correlation with gender, smoking, diabetes, high blood pressure, blood＆amp;nbsp;lipids;②HCY was positively correlated with gender, smoke, NIHSS and LP （ a ） .Conclusion Lp-PLA2 and HCY were all increased in acute ischemic stroke, and they had a significant correlation, combined detection can provide some help for the clinic treatment and secondary prevention.