远程缺血预适应训练对短暂性脑缺血发作患者血清Lp-PLA2 HIF-1α水平及终点事件的影响

Effect of remote ischemic preconditioning training on levels of serum Lp-PLA2 and HIF-1α and endpoint events in patients with TIA

目的探讨远程缺血预适应训练对短暂性脑缺血发作(TIA)患者血清人血浆脂蛋白磷脂酶A2(Lp-PLA2)、血清缺氧诱导因子-1α(HIF-1α)水平及终点事件的影响。方法选取平顶山市第二人民医院于2020-01—2020-12收治的TIA患者116例,训练组58例和对照组58例,对照组采用普通治疗方法,训练组在对照组的基础上干预远程缺血预适应训练,检测血清Lp-PLA2、HIF-1α、α-颗粒膜蛋白(GMP)、溶血磷脂酸(LPA)水平,观察终点事件发生率。结果治疗前2组血清Lp-PLA2、HIF-1α、GMP、LPA水平分别为(14.69±4.91)μg/L、(363.87±99.68)pg/mL、(53.26±13.78)μmol/L、(4.36±0.97)μmol/L和(14.61±4.72)μg/L、(362.85±98.72)pg/mL、(54.02±12.60)μmol/L、(4.41±0.96)μmol/L,差异均无统计学意义(P>0.05);治疗1、3、6 h后训练组的血清Lp-PLA2水平分别为(11.52±5.82)μg/L、(9.83±3.58)μg/L、(8.53±3.54)μg/L,低于对照组的(13.95±4.99)μg/L、(12.02±4.02)μg/L、(11.52±3.43)μg/L,差异均有统计学意义(P<0.05);治疗1、3、6 h后训练组血清HIF-1α水平分别为(301.82±89.82)pg/mL、(257.24±80.58)pg/mL、(163.46±75.28)pg/mL,低于对照组的(335.23±84.99)pg/mL、(294.23±76.02)pg/mL、(206.35±73.43)pg/mL,差异有统计学意义(P<0.05);治疗6 h后训练组血清GMP、LPA水平分别为(24.65±6.71)μmol/L、(2.05±0.47)μmol/L,低于对照组的(30.36±6.99)μmol/L、(2.87±1.15)μmol/L,差异有统计学意义(P<0.05);治疗后训练组终点事件发生率3.44%,低于对照组的15.51%,差异有统计学意义(P<0.05)。结论远程缺血预适应训练可减少TIA患者终点事件发生率,使血清Lp-PLA2、HIF-1α、GMP、LPA水平降低。

Objective To investigate the effect of remote ischemic preconditioning training on levels of serum human plasma lipoprotein phospholipase A2(Lp-PLA2)and serum hypoxia-inducible factor-1α(HIF-1α)and endpoint events in patients with transient ischemic attack(TIA).Methods patients with TIA admitted to the hospital between January 2020 and December 2020 were selected.The patients were divided into training group(n=58)and control group(n=58).The control group adopted common treatment method,and the training group intervened the remote ischemic preconditioning training on the basis of the control group.The levels of serum Lp-PLA2,HIF-1α,α-granule membrane protein(GMP)and lysophosphatidic acid(LPA)and incidence rates of endpoint events were observed and measured.ResultsBefore treatment,the levels of serum Lp-PLA2,HIF-1α,GMP and LPA in the two groups were(14.69±4.91)μg/L,(363.87±99.68)pg/mL,(53.26±13.78)μmol/L and(4.36±0.97)μmol/L and(14.61±4.72)μg/L,(362.85±98.72)pg/mL,(54.02±12.60)μmol/L and(4.41±0.96)μmol/L,without statistical significance(P>0.05).The levels of serum Lp-PLA2 after 1 h,3 h and 6 h of treatment of(11.52±5.82)μg/L,(9.83±3.58)μg/L and(8.53±3.54)μg/L in training group were lower than(13.95±4.99)μg/L,(12.02±4.02)μg/L and(11.52±3.43)μg/L in control group(P<0.05).After 1 h,3 h and 6 h of treatment,the levels of serum HIF-1αof(301.82±89.82)pg/mL,(257.24±80.58)pg/mL and(163.46±75.28)pg/mL intraining group were lower than(335.23±84.99)pg/mL,(294.23±76.02)pg/mL and(206.35±73.43)pg/mL in control group(P<0.05).The levels of serum GMP and LPA of(24.65±6.71)μmol/L and(2.05±0.47)μmol/L in training group after 6 h of treatment were lower than(30.36±6.99)μmol/L and(2.87±1.15)μmol/L in control group(P<0.05).The incidence rate of endpoint events of 3.44%in training group after treatment was lower than 15.51%in control group(P<0.05).ConclusionRemote ischemic preconditioning training can reduce the incidence rates of end-point events,and lower the levels of serum Lp-PLA2,HIF-1α,GMP and LPA in patients with TIA.