改良FSP、CVHI联合Lp-PLA2预测脑卒中

Modified Framingham stroke profile,cerebral vascular hemodynamic indexes and Lp-PLA2 in prediction of stroke

目的探讨以改良弗明汉卒中风险评分(FSP)、脑血流动力学指标(CVHI)及脂蛋白磷脂酶A2(Lp-PLA2)构建的脑卒中预测模型对脑卒中的预测能力。方法收集101例首发缺血性脑卒中患者和156名社区非脑卒中常住人口的临床资料。利用多因素Logistic回归分析FSP、CVHI及Lp-PLA2预测脑卒中发生的价值,建立单纯FSP、FSP+CVHI、FSP+Lp-PLA2、FSP+CVHI+LpPLA2预测模型,通过受试者工作特征曲线(ROC)的曲线下面积(AUC)分析各模型的脑卒中预测能力。结果 FSP、CVHI、Lp-PLA2每增加1个等级发生脑卒中的风险分别增加2.85、3.25、7.75倍(P值分别为0.043、0.036、<0.001)。单纯FSP、FSP+CVHI、FSP+Lp-PLA2、FSP+CVHI+LpPLA2预测模型ROC的AUC分别为0.588、0.845、0.858和0.936。结论 FSP+CVHI+Lp-PLA2预测模型可有效预测脑卒中的发生。

Objective To assess the value of the model established by modified Framingham riskscore(FS P),cerebral vascular hemodynamic indexes(CVHI)combined with lipoprotein phospholipase A2(Lp-PLA2)in prediction of stroke.Methods Clinical data of101patients with primary ischemic stroke and156community residents without stroke were collected.Multivariate Logistic regression analysis was performed to evaluate the values of FSP,CVHI and Lp-PLA2in prediction of stroke.FSP,FSP+CVHI,FSP+Lp-PLA2and FSP+CVHI+Lp-PLA2prediction models were established.The predictive ability of each model was analyzed by using the area under receiver operating characteristic(ROC)curve(AUC).Results The risk of stroke was increased by2.85,3.25and7.75times when the FSP,CVHI and Lp-PLA2were elevated by1grade(P=0.043,0.036and<0.001).The ROC AUC of FSP,FSP+CVHI,FSP+Lp-PLA2and FSP+CVHI+Lp-PLA2prediction models were0.588,0.845,0.858and0.936,respectively.Conclusion FSP+CVHI+Lp-PLA2prediction model can effectively predict the incidence of stroke.