Lp-PLA2与高血压患者发生缺血性脑卒中及预后的相关性分析

Analysis on correlation between serum Lp-PLA2 level with ischemic stroke occurrence and prognosis in patients with hypertension

目的探讨血浆脂蛋白磷脂酶A2(Lp-PLA2)与高血压患者发生缺血性脑卒中及其与预后的相关性。方法选取2013年1月至2016年1月该院确诊的高血压患者88例,其中单纯性高血压患者34例,高血压合并缺血性脑卒中患者54例,检测患者Lp-PLA2水平。在入院第1天和第14天采用美国国立卫生研究院卒中量表(NIHSS)对患者脑卒中严重程度进行评分,根据NIHSS变化情况将高血压合并缺血性脑卒中患者分为预后良和预后差,并采用Logistics多元回归评价预后的独立预测因素。结果高血压合并缺血性脑卒中患者Lp-PLA2水平显著高于单纯性高血压患者,Lp-PLA2水平(OR=1.523,95%CI=1.323~1.657)和入院NIHSS评分(OR=3.275,95%CI=1.402~6.208)是缺血性脑卒中患者预后不良的独立预测因素。结论血清Lp-PLA2与高血压患者中缺血性脑卒中的发生与预后密切相关,可作为高血压患者缺血性脑卒中发生和预后的评价指标为临床治疗提供客观依据。

Objective To explore the correlation between serum lipoprotein-associated phosphol ipase A2 （Lp-PLA2） level with the occurrence of ischemic stroke and prognosis in the patients with hypertension. Methods Eighty-eight patients with hypertension in this hospital from January 2013 to January 2016 were selected, including 34 cases of simple hypertension and 54 cases of hypertension complicating ischemic stroke. The Lp-PLA2 level was detected. The severity of ischemic stroke was evaluated on 1,14 d after admission by adopting the NIHSS. The patients with hypertension complicating ischemic stroke were divided into the good prognosis group and poor prognosis group according to the NIHSS change situation. Moreover the independent predictive factors of prognosis were evaluated by adopting the Logistic multivariate regression. Results The Lp-PLA2 level in the patients with hypertension complicating ischemic stroke was significantly higher than that in the patients with simple hypertension. The Lp-PLA2 level （OR= 1. 523 ,9 5% C I= 1 . 323 - 1. 6 5 7 ） and NIHSS score （OR=3. 275,95%CI=1. 402 -6. 2 0 8 ） at admission were the independent predictive factors of poor prognosis. Conclusion Serum Lp-PLA2 level is closely correlated wi th the occurrence and prognosis of ischemic stroke in the patients with hypertension,which can serve an evaluation index for the occurrence and prognosis of ischemic stroke in the patients with hypertension and provides an objective basis for the clinical therapy.