急性缺血性卒中合并颈动脉斑块患者神经功能损伤与血浆氧化低密度脂蛋白水平相关性研究

Association Study between Neurological Deficits and Plasma ox-LDL in Patients with Carotid Plaque Related Acute Ischemic Stroke

目的探讨急性缺血性卒中(acute ischemic stroke,AIS)合并颈动脉斑块的患者神经功能损伤与血浆氧化低密度脂蛋白(oxidized low-density lipoprotein,ox-LDL)水平的相关性。方法本研究入选患者来自急性缺血性卒中患者氧化应激水平的临床观察研究(Study on Oxidative Stress in Patients with Acute Ischemic Stroke,SOS-Stroke)。选取经颈动脉超声证实存在颈动脉斑块的AIS患者。所选患者入院24 h内均行美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,评估神经功能损伤的严重程度,并用酶联免疫吸附法(enzyme-linked immuno sorbent assay,ELISA)检测血浆ox-LDL水平。采用多元线性回归模型分析NIHSS评分与ox-LDL水平的关系。结果本研究共纳入2421例患者,ox-LDL平均水平为(56.55±20.86)μg/dl,平均NIHSS评分为4(2~8)分。在线性回归模型中,校正年龄、性别、糖尿病及高血压等因素后发现,血浆ox-LDL水平对NIHSS评分有影响,且ox-LDL每升高10个单位,NIHSS增加0.23分(P<0.0001)。年龄、性别和斑块是否稳定对NIHSS评分与ox-LDL水平的关系无显著影响。结论 AIS患者神经功能损伤与血浆ox-LDL水平具有正相关性。

Objective To evaluate the correlation between neurological deficits and plasma level of oxidized low density lipoprotein （ox-LDL） in patients with carotid plaque related acute ischemic stroke （AIS）. Methods Patients who had carotid plaques diagnosed by carotid ultrasound were recruited from the Study on Oxidative Stress in Patients with Acute Ischemic Stroke （SOS-Stroke）. The severity of neurological deficits were assessed by the National Institutes of Health Stroke Scale （NIHSS） in all patients, and plasma level of ox-LDL was also measured by enzyme-linked immuno sorbent assay （ELISA） within 24 hours of admission. The correlation of NIHSS scores and plasma levels of oxLDL were evaluated in multiple linear regression analysis models. Results The study included 2421 patients. The mean ＋ Standard Deviation （SD） of the NIHSS scores and the ox-LDL levels were 4 （2-8） and （56.55±20.86） μg/dl, respectively. In linear regression analysis models of the influence of plasma ox-LDL levels on NIHSS scores, plasma ox-LDL levels had a significant effect on NIHSS scores and NIHSS scores increased 0.23 per elevated 10 units ofox-LDL after adjusted for potential confounding factors including age, gender, diabetes, hypertension and so on （P〈0.0001）. And the stability of carotid plaques, age and gender had no remarkable influence on the relation between NIHSS scores and plasma ox-LDL levels. Conclusion There is significantly positive correlation of neurological deficits and plasma ox-LDL in patients with acute ischemic stroke combining carotid plaque.