脂蛋白相关磷脂酶A2与缺血性脑卒中的相关性研究

Correlation between Lipoprorein-assoeiated phosPhohPaseA2 and ischemic stroke

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)与缺血性脑卒中的相关性。方法选取2016年4月-2019年12月海南省三亚市人民医院收治的缺血性脑卒中患者94例作为研究组,并根据入院时美国国立卫生研究院卒中量表评分(NIHSS)将患者分为神经功能缺损轻度组31例、中度组49例、重度组14例;根据出院时改良Rankin量表评分(mRS)将患者分为预后不良组25例、预后良好组69例;另同期体检健康者92例作为对照组。比较各组血清Lp-PLA2水平,分析Lp-PLA2与患者神经功能缺损及预后的关系。结果研究组血清Lp-PLA2水平高于对照组,差异有统计学意义(P<0.05)。重度组血清Lp-PLA2水平高于中度组、轻度组;中度组血清Lp-PLA2水平高于轻度组,差异有统计学意义(P<0.05)。Pearson分析显示,Lp-PLA2与神经功能缺损呈正相关(r=0.779,P=0.000)。预后不良组血清Lp-PLA2水平高于预后良好组,差异有统计学意义(P<0.05)。Logistic回归分析显示,Lp-PLA2是患者短期预后不良的独立危险因素(P<0.05)。ROC曲线分析显示,Lp-PLA2预测患者短期预后的AUC为0.802,最佳临界值为370.57,灵敏度为72%、特异度为81.2%。结论Lp-PLA2与缺血性脑卒中发生、发展密切相关,是评估患者神经功能缺损程度的重要指标,对患者短期预后具有一定预测价值。

Objective To investigate the relationship between Lp-PLA2 and ischemic stroke.Methods 94 patients with ischemic stroke admitted to Sanya people’s Hospital from April 2016 to December 2019 were selected as the study group.According to the NIHSS score,the patients were divided into the mild group(31 cases),moderate group(49 cases)and severe group(14 cases).According to the mRS score,the patients were divided into the poor prognosis group(25 cases)and the good prognosis group(69 cases).In the same period,92 healthy persons were selected as control group.To compare the level of Lp-PLA2 in serum of each group,and analyze the relationship between Lp-PLA2 and neurological deficit and prognosis.Results The level of Lp-PLA2 in the study group was significantly higher than that in the control group(P<0.05).The level of Lp-PLA2 in severe group was higher than that in moderate group and mild group,and the level of Lp-PLA2 in moderate group was higher than that in mild group(P<0.05).Pearson analysis showed that,Lp-PLA2 was positively correlated with neurological deficit(r=0.779,P=0.000).The level of Lp-PLA2 in poor prognosis group was higher than that in good prognosis group(P<0.05).Logistic regression analysis showed that,the AUC was 0.802,the best critical value was 370.57,the sensitivity was 72%,and the specificity was 81.2%of Lp-PLA2 predicted the short-term prognosis of patients.Conclusion Lp-PLA2 is closely related to the occurrence and development of ischemic stroke.It is an important index to evaluate the degree of neurological deficit in patients and has a certain predictive value for the short-term prognosis of patients.