脂蛋白相关磷脂酶A2与青年缺血性脑卒中关系的临床研究

Clinical study on the relationship of lipoprotein-associated phospholipase A2 in young ischemic stroke

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平与青年缺血性脑卒中(IS)的关系。方法连续性纳入濮阳市人民医院2018-06—2019-12收治的113例青年缺血性脑卒中患者为脑梗死组,32例短暂性脑缺血发作(TIA)患者为TIA组,34例周围性眩晕患者为眩晕组(非缺血性脑血管病对照组)。脑梗死组依据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度脑卒中组(NIHSS≤4分)、中度脑卒中组(5~15分)、重度脑卒中组(16~17分)。3个月后脑梗死患者随访,依据改良Rankin量表(mRS)将其分为预后良好组(0~2分)、预后不良组(3~5分)。血浆Lp-PLA2水平检测采用免疫层析法。结果脑梗死组、TIA组及眩晕组血浆Lp-PLA2水平均呈下降趋势,分别为(249.47±98.24)ng/mL、(208.19±87.43)ng/mL、(149.50±73.05)ng/mL,差异有统计学意义(P<0.05)。重度、中度及轻度脑卒中组血浆Lp-PLA2水平比较呈下降趋势,分别为(323.67±107.96)ng/mL、(257.25±95.34)ng/mL、(206.31±85.96)ng/mL,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,血浆Lp-PLA2水平是青年缺血性脑卒中的危险因素。预后良好组血浆Lp-PLA2水平低于预后不良组,差异有统计学意义(P<0.05)。结论青年IS患者血浆Lp-PLA2水平升高,且NIHSS评分越高,血浆Lp-PLA2水平越高。血浆Lp-PLA2水平是青年脑梗死的危险因素,血浆Lp-PLA2水平与青年脑梗死患者的发病、严重程度、预后相关。

Objective To investigate the relationship between the serum lipoprotein-associated phospholipase A2(Lp-PLA2)and young ischemic stroke(IS).Methods Totally 113 young patients with ischemic stroke admitted continuously in Puyang People’s Hospital from June 2018 to December 2019 were included in the cerebral infarction group.During this period,32 patients with tran⁃sient ischemic attack were included in TIA group and 34 patients with peripheral vertigo were included in vertigo group(non-ischemic cerebrovascular disease control group).According to the National Institutes of Health stroke scale(NIHSS)score,the cerebral infarc⁃tion group was divided into the mild stroke group(NIHSS≤4 points),moderate stroke group(5-15 points)and severe stroke group(16-17 points).Patients with cerebral infarction were followed up after three months,who were divided into good prognosis group(0-2 points)and poor prognosis group(3-5 points)according to the modified Rankin Scale(mRS).Immunochromatographic meth⁃od was used to detect the serum Lp-PLA2 level.Results The serum Lp-PLA2 levels of cerebral infarction group,transient isch⁃emic attack group and vertigo group showed a decreasing trend,which were(249.47±98.24)ng/mL,(208.19±87.43)ng/mL and(149.50±73.05)ng/mL,and the difference was statistically significant(P<0.05).The serum Lp-PLA2 levels of severe stroke group,moderate stroke group and mild stroke group showed a decreasing trend,which were(323.67±107.96)ng/mL,(257.25±95.34)ng/mL and(206.31±85.96)ng/mL,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis revealed that serum Lp-PLA2 levels are risk factors for ischemic stroke in youth.The serum Lp-PLA2 level of the group with good prognosis was lower than that of the poor prognosis group,and the difference was statistically significant(P<0.05).Conclusion The serum Lp-PLA2 level increased in young patients with IS,and the higher the NIHSS score,the higher the serum Lp-PLA2 level.The se⁃rum Lp-PLA2 levels are risk factors for youth IS.The serum Lp-PLA2 levels are associated with morbidity,severity and prognosis.