血清脂蛋白相关磷脂酶A2水平与急性缺血性脑卒中患者病情及预后的关系

The relationship between the level of serum lipoprotein associated phospholipase A2 and the condition and prognosis of patients with acute ischemic stroke

目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平与急性缺血性脑卒中患者病情及预后的关系。方法收集120例急性缺血性脑卒中者和92例健康体检者的一般资料,采用酶联免疫吸附法检测血清Lp-PLA2水平,于患者入院时采用NIHSS量表评估病情严重程度,于患者出院后3个月采用mRS量表评估预后,分析血清Lp-PLA2水平与患者病情严重程度的相关性,并分析影响患者预后的危险因素。结果急性缺血性脑卒中组患者的高血压比例、血清Lp-PLA2水平明显高于对照组,差异均具有统计学意义(P<0.05)。120例急性缺血性脑卒中患者中轻度47例、中度38例、重度35例,3组患者的血清Lp-PLA2水平相比差异有统计学意义(P<0.05)。Pearson相关分析结果显示,血清Lp-PLA2水平与患者NIHSS评分呈正相关(P<0.05)。120例急性缺血性脑卒中患者中预后良好81例、预后不良39例,预后不良组患者的年龄显著大于预后良好组(P<0.05)、发病至入院时间显著长于预后良好组(P<0.05),血清Lp-PLA2水平显著高于预后良好组(P<0.05)。多因素Logistic回归分析结果显示,年龄、Lp-PLA2是急性缺血性脑卒中患者预后的危险因素(P<0.05)。结论急性缺血性脑卒中患者血清Lp-PLA2水平越高,则患者的病情严重程度越重,Lp-PLA2是急性缺血性脑卒中患者预后的危险因素。

Objective To investigate the relationship between the level of Lp-PLA2 and the condition as well as prognosis of patients with acute ischemic stroke.Methods The general data of 120 patients with acute ischemic stroke and 92 healthy persons were collected.The serum Lp-PLA2 levels were detected by ELISA.NIHSS scale was used to assess the severity of the disease at admission.mRS was used to evaluate the prognosis 3 months after discharge.The correlation between serum Lp-PLA2 level and the severity of the disease was analyzed.The risk factors of prognosis were analyzed.Results The proportion of hypertension and the level of serum Lp-PLA2 in patients with acute ischemic stroke were significantly higher than those in control group(P<0.05).Among 120 patients with acute ischemic stroke,47 cases were mild,38 cases were moderate,and 35 cases were severe.There was significant difference in serum Lp-PLA2 level among the three groups(P<0.05).Pearson correlation analysis showed that serum Lp-PLA2 levels were positively correlated with NIHSS score(P<0.05).Among 120 patients with acute ischemic stroke,81 cases had good prognosis and 39 cases had poor prognosis.The age of patients in poor prognosis group was significantly longer than that in good prognosis group(P<0.05),the time from onset to admission was significantly longer than that in good prognosis group(P<0.05),and serum Lp-PLA2 levels were significantly higher than that in good prognosis group(P<0.05).Multivariate logistic regression analysis showed that age and Lp-PLA2 were risk factors for prognosis of patients with acute ischemic stroke(P<0.05).Conclusion The higher the level of Lp-PLA2,the more serious the disease is.Lp-PLA2 is a risk factor of prognosis in patients with acute ischemic stroke.