动脉粥样硬化血栓形成性脑卒中血清Lp-PLA2水平的研究

The research of Lp-PLA2 in patients with atherosclerosis acute ischemic stroke

目的 探讨动脉粥样硬化血栓形成性（AT）脑卒中患者血清脂蛋白相关磷脂A2（Lp-PLA2）水平的变化,并探讨其与脑梗死体积、神经功能缺损程度和早期预后之间的关系。方法 选取于2014~2015年在河北省人民医院就诊的AT性脑卒中患者104例为研究对象（卒中组）,健康体检者100例作为对照组,比较两者Lp-PLA2水平的差异;并采用Pullicino公式计算脑梗死体积,采用美国国立卫生研究所脑卒中量表（NIHSS）进行脑神经功能缺损程度评估,采用日常生活活动能力评定（Barthel）指数判断患者短期预后,比较不同脑卒中体积和不同脑神经损伤程度患者血清Lp-PLA2水平变化,以及Lp-PLA2水平对患者短期预后的影响。结果 卒中组患者血清Lp-PLA2水平高于对照组,差异有统计学意义（P〈0.05）,且与血清LDLC水平呈正相关（r=0.859,P〈0.05）;卒中组患者血清Lp-PLA2水平随脑梗死体积的增大而升高,随脑神经功能缺损程度的增加而升高,均呈正相关（r=0.531、0.623,P〈0.05）,Lp-PLA2水平高的患者短期预后较差（P〈0.05）。结论 AT脑卒中患者Lp-PLA2水平明显增高,可作为判断病情严重程度和短期预后的血清学指标。

Objective To observe the changes of lipoprotein-associated phospholipase A2（Lp-PLA2） in patients with atherothrombosis acute ischemic stroke and the correlation of Lp-PLA2 with cerebra infarction volume,neurologic impairment and early prognosis. Methods A total of 104 patients with atherothrombosis acute ischemic stroke and 100 healthy people（controls） were collected. The levels of Lp-PLA2 were detected by immunoturbidimetry. The cerebral infarction volume was checked by Cranial MRI or CT. The neurological impairment degree was assessed by National Institute of Health Stroke Scale （NIHSS） score. The early prognosis was assessed by Barthe[ index. The changes of serum Lp-PLA2 levels in patients with different infarct volumes and neurologic impairment were compared,the influence of early prognosis were analysised. Results The levels of serum Lp-PLA2 in the patients with atherothrombosis ischemic stroke were significantly higher than those in control group （P〈0.05）, and significantly correlated with the levels of serum LDLC（r=0. 859 ,P〈0.05）. The levels of serum Lp-PLA2 were significantly correlated with the increasing of cerebral infarction volume and cerebral neurological impairments（r=0. 531 ,P〈0.05;r=0. 623 ,P〈0.05）. The patients with higher level of Lp-PLA2 has poor prognosis（P〈0.05）. Conclusion The level of Lp-PLA2 was significantly higher in patients with atherothrombosis ischemic stroke and may reflect the severity and early prognosis in patients with atherothrombosis acute ischemic stroke.