血清脂蛋白相关磷脂酶A2在后循环缺血性脑梗死预后中的意义研究

The significance of serum lipoprotein-associated phospholipase A2 in the prognosis of posterior circulation ischemic cerebral infarction

目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)在后循环缺血性脑梗死(PCCI)预后中的意义。方法选择2017年12月—2019年10月在南阳市第二人民医院就诊的PCCI患者112例作为PCCI组;另选择同期在本院的健康体检者60名作为对照组。根据入院NIHSS评分将PCCI组分为轻度(54例)、中度(45例)和重度PCCI组(13例)三组;根据发病30天后的mRS评分将PCCI患者分为预后不良组(40例)和预后良好组(72例)两组。检测比较各组入院时Lp-PLA2水平,采用相关性和Logistic回归分析Lp-PLA2水平与PCCI病情及预后的关系,ROC曲线评估Lp-PLA2水平在PCCI、轻、中、重度PCCI组内对预后的预测价值。结果PCCI组Lp-PLA2水平显著高于对照组,且预后不良组高于预后良好组,重度组高于中度组和轻度组(P<0.05);Lp-PLA2水平与PCCI患者NIHSS和mRS评分呈正相关性;Lp-PLA2是PCCI预后的独立影响因子;PCCI组、轻、中、重亚组组内Lp-PLA2诊断预后不良的ROC曲线下面积分别为0.779、0.718、0.792、0.778。结论Lp-PLA2水平与PCCI预后及病情严重程度相关,可能成为临床诊断及预后评估的辅助指标,具有一定的临床价值。

Objective To investigate the significance of serum lipoprotein-related phospholipase A2(Lp-PLA2)in the prognosis of posterior circulation ischemic cerebral infarction(PCCI).Methods 112 PCCI patients who were admitted to Nanyang second people's hospital from December 2017 to October 2019 were collected as PCCI group,60 healthy people who took medical examination during the same period were selected as control group.PCCI group were divided into the mild group(n=54),moderate group(n=45),and severe group(n=13)according to the NIHSS score at admission.PCCI patients were divided into poor prognosis group(n=40)and good prognosis group(n=72)according to the mRS score 30d after onset.The Lp-PLA2 levels at admission were detected in each group,correlation and Logistic regression were used to analyze the relationship between LP-PLA2 level and PCCI condition and prognosis,the predictive value of Lp-PLA2 levels in PCCI,mild,moderate,and severe groups were evaluated by ROC curve.Results Lp-PLA2 levels in the PCCI group were significantly higher than those in the control group,while those in poor prognosis group were higher than good prognosis group,those in severe group were higher than moderate group and mild group(all P<0.05).Lp-PLA2 levels were positively correlated with NIHSS and mRS scores in PCCI patients.Lp-PLA2 was an independent factor for PCCI prognostic.The area under the ROC curve for diagnosing poor prognosis of Lp-PLA2 in the PCCI group,mild,moderate,and severe subgroups were 0.779,0.718,0.792,and 0.778,respectively.Conclusions The level of Lp-PLA2 is related to the prognosis of PCCI and the severity of the disease,which may be an auxiliary indicator for clinical diagnosis and prognosis assessment and with certain clinical value.