急性小动脉闭塞性脑梗死患者脂蛋白相关磷脂酶A2与脑白质疏松严重程度的相关性研究

Correlation between plasma lipoprotein-associated phospholipase A2 and the severity of leukoaraiosis in patients with acute small-artery-occlusion stroke

目的探讨急性小动脉闭塞性脑梗死患者血浆脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)水平与脑白质疏松(LA)严重程度的关系。方法收集2019-12—2020-07在南通大学第二附属医院神经内科接受治疗的急性缺血性脑卒中患者,纳入急性小动脉闭塞性脑梗死患者142例。采用Fazekas评分法对脑白质疏松进行评分,将患者分为轻度LA组90例(Fazekas评分0~3分),重度LA组52例(Fazekas评分4~6分)。单因素分析及多因素Logistic回归分析Lp-PLA2、空腹血糖、低密度脂蛋白胆固醇、甘油三酯、高密度脂蛋白胆固醇、高敏C反应蛋白、糖化血红蛋白、同型半胱氨酸等因素与LA严重程度的关系。结果单因素分析显示,重度LA组患者年龄、hs-CRP、Lp-PLA2水平均高于轻度LA组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄(OR=1.089,95%CI:1.044~1.135,P=0.000)、Lp-PLA2(OR=1.006,95%CI:1.002~1.011,P=0.007)是急性小动脉闭塞性脑梗死患者LA严重程度增加的独立危险因素。结论Lp-PLA2水平与急性小动脉闭塞性脑梗死LA严重程度呈正相关。

Objective To investigate the relationship between plasma lipoprotein-associated phospholipase A2(Lp-PLA2)level and the severity of leukoaraiosis level(LA)in patients with acute small-artery-occlusion cerebral infarction.Methods Totally 142 patients with acute small-artery-occlusion cerebral infarction,admitted to our hospital from December 2019 to July 2020 were analyzed in this study.According to Fazekas rating scale,patients were divided into mild LA group(n=90,Fazekas score 0-3)and se⁃vere LA group(n=52,Fazekas score 4-6).Univariate analysis and multivariate logistic regression analysis were used to analyze the relationship between Lp-PLA2,fasting blood glucose,triglyceride,low-density lipoprotein,high-density lipoprotein,high-sensitivity C-reactive protein(hs-CRP),hemoglobin A1c,homocysteine and the severity of LA.Results Univariate analysis showed that age,hs-CRP and Lp-PLA2 levels in severe LA group were higher than mild LA group(P<0.05).Multivariate Logistic regression analysis indicated that age(OR=1.089,95%CI:1.044-1.135,P=0.000)and Lp-PLA2(OR=1.006,95%CI:1.002-1.011,P=0.007)were inde⁃pendent risk factors for the severity of LA in patients with acute small-artery-occlusion stroke.Conclusion Plasma Lp-PLA2 level is positively correlated with LA severity of acute small-artery-occlusion stroke.