脂蛋白相关磷脂酶A2对大动脉粥样硬化型脑梗死预后的影响

Effects of lipoprotein related phospholipase A2 on the prognosis of large artery atherosclerosis cerebral infarction

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)对大动脉粥样硬化型脑梗死预后的影响。方法收集诊断明确的大动脉粥样硬化型脑梗死患者62例。依据Lp-PLA2水平分为低水平组(n=32例)和高水平组(n=30例)。分别对两组患者入院时、1 m时、6 m时的临床疗效及侧支循环开放程度进行评估,比较两组间差异。结果低水平组和高水平组两组入院时NIHSS评分、Barthel指数(BI)评分及mRS评分均无显著差异(P> 0. 05)。第1月时低水平组NIHSS评分及mRS评分均低于高水平组(P <0. 05),BI评分两组间无显著性差异(P> 0. 05);第6月时低水平组NIHSS评分及mRS评分均低于高水平组(P <0. 01),BI评分高于高水平组(P <0. 05);低水平组第1月时(P <0. 05)及6 m时(P <0. 01)侧支循环开放率均高于高水平组。低水平组6 m内脑梗死复发率显著低于高水平组(P <0. 05)。结论 Lp-PLA2水平与大动脉粥样硬化型脑梗死的预后密切相关。

Objective To evaluate the effects of lipoprotein related phospholipase A2 on the prognosis of large artery atherosclerosis cerebral infarction. Methods Sixty-two patients with large artery atherosclerosis cerebral infarction were diagnosed and collected. According to levels of Lp-PLA2,they were divided into low level group( n = 32) and high level group( n = 30). At the time of admission,one month and six months,the clinical efficacy and the degree of collateral circulation opening were evaluated in the two groups,and the differences between the two groups were compared. Results There was no significant difference in NIHSS score,Barthel Index( BI) score and mRS score between the low level group and the high level group at admission( P > 0. 05). NIHSS score and the mRS score of the low level group were lower than those in the high level group after one month( P < 0. 05),and there was no significant difference between the two groups regarding the BI scores( P > 0. 05). After six months,the NIHSS score and the mRS score of the low level group were lower than those in the high level group( P < 0. 01),and the BI score was higher than that in the high level group( P < 0. 05). After 1 month( P < 0. 05) and 6 months( P < 0. 01),the collateral circulation opening rate of lower level group was higher than that in the high level group. The recurrence rate of cerebral infarction in low level group was significantly lower than that in high level group within 6 months( P < 0. 05). Conclusion Lp-PLA2 is closely related to the prognosis of large artery atherosclerosis cerebral infarction.