血浆脂蛋白相关磷脂酶A2水平与脑梗死患者神经功能缺损程度、梗死体积及其预后的关系

Relationship between plasma lipoprotein associated phospholipase A2 level and neurologic impairment degree, infarct volume and prognosis in patients with cerebral infarction

目的探讨血浆脂蛋白相关磷脂酶A2水平与脑梗死患者神经功能缺损程度、梗死体积及其预后的关系。方法选取我院2015年1月～2017年2月间连续入组的100例急性脑梗死患者,以酶联免疫吸附法对患者Lp-PLA2水平进行检测。根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻度、中度、重度患者;根据梗死灶的大小分为小梗死灶、中梗死灶、大梗死灶;在90d后通过电话随访,采用改良Rankin量表(mRS)对其预后进行评价(mRS评分≤2分为预后良好,mRS评分> 2分为预后较差),从而探讨神经功能缺损程度评分、梗死灶大小、预后和患者Lp-PLA2之间的关系。结果根据NIHSS评分分组,可知轻度、中度、重度患者Lp-PLA2水平逐渐升高;小梗死灶、中梗死灶、大梗死灶患者Lp-PLA2水平逐渐升高;mRS评分≤2分的预后良好组患者低于mRS评分> 2分的预后较差组患者。经相关性分析,可知脑梗死患者Lp-PLA2水平与神经功能缺损程度评分(r=0.682,P <0.05)、梗死体积(r=0.741,P <0.05)、90d mRS得分(r=0.790,P <0.05)均为正相关。结论脑梗死患者Lp-PLA2和脑梗死体积、神经功能缺损程度、90d mRS得分之间相关,在一定程度上可通过Lp-PLA2的检测来评估患者病情及预后情况。

Objective To explore the relationship between plasma lipoprotein associated phospholipase and neurologic impairment degree,infarct volume and prognosis in patients with cerebral infarction.Methods 100 patients with acute cerebral infarction who were continuously enrolled from January 2015 to February 2017 were selected and Lp-PLA2 level of them were detected by enzyme-linked immunosorbent assay.According to National Institutes of Health Stroke Scale(NIHSS)score,patients were divided into mild,moderate,and severe patients.According to the size of infarcted focus,they were divided into small infarcted focus,middle infarcted focus and large infarcted focus.After 90 days of follow-up by telephone,the prognosis was evaluated by using a modified Rankin scale(mRS)(mRS score≤2 indicated good prognosis,while mRS score>2 indicated poor prognosis).Then the relationship between neurologic impairment degree,the size of infarcted focus,prognosis and Lp-PLA2 was explored.Results According to the NIHSS score,the level of Lp-PLA2 was increased gradually in mild,moderate and severe patients.The level of Lp-PLA2 was increased gradually in patients with small,middle and large infarcted focus.The level of Lp-PLA2 in patients with good prognosis and mRS score≤2 was lower than that of patients with poor prognosis and mRS score>2.According to the correlation analysis,the level of Lp-PLA2 in patients with cerebral infarction was positively correlated with neurologic impairment degree score(r=0.682,P<0.05),infarct volume(r=0.741,P<0.05)and mRS score of 90 days(r=0.790,P<0.05).Conclusion Level of Lp-PLA2 in patients with cerebral infarction is correlated to cerebral infarct volume,neurologic impairment degree and mRS score of 90 days.To some extent,the patient’s condition and prognosis can be assessed by Lp-PLA2 detection.