LP-PLA2与经颅多普勒超声对急性缺血性脑卒中预后的预测价值

Predictive value of LP-PLA2 and transcranial Doppler ultrasound in the prognosis of acute ischemic stroke

目的探讨脂蛋白相关磷脂酶A2(LP-PLA2)与经颅多普勒超声(TCD)对急性缺血性脑卒中(AIS)预后的预测价值。方法回顾性分析2017年4月至2019年7月广东省人民医院南海医院(以下简称"我院")收治的171例AIS患者的临床资料,记为研究组,并回顾分析同期在我院进行体检的61名健康志愿者的体检资料,记为对照组。根据脑梗死面积将AIS患者分为轻度、中度及重度梗死患者,并比较其LP-PLA2、TCD参数搏动指数(PI)、收缩期峰值流速(PSV)以及平均血流速度(MV),比较两组LP-PLA2、PI、PSV及MV,分析AIS患者预后不良的影响因素,分析LP-PLA2、PI、PSV及三者对ASI患者预后不良的预测价值。结果研究组LP-PLA2、PI高于对照组,PSV、MV低于对照组(P<0.05)。重度梗死患者LP-PLA2、PI高于轻度和中度梗死患者(P<0.05),中度梗死患者LP-PLA2、PI高于轻度梗死患者(P<0.05);重度梗死患者PSV、MV低于轻度和中度梗死患者(P<0.05),中度梗死患者PSV、MV低于轻度梗死患者(P<0.05)。预后不良者LP-PLA2、PI、意识障碍者占比高于预后良好者,PSV、MV低于预后良好者(P<0.05)。LP-PLA2、PI、PSV、意识障碍均为AIS患者预后不良的影响因素(P<0.05)。LP-PLA2、PI、PSV及三者联合对AIS患者预后不良的曲线下面积值分别为0.783、0.785、0.744、0.915(P<0.05)。结论LP-PLA2、TCD参数PI、PSV均可用于预测AIS患者预后。

Objective To explore the prognostic value of lipoprotein-related phospholipase A2(LP-PLA2)and transcranial Doppler ultrasound(TCD)in the prognosis of acute ischemic stroke(AIS).Methods The clinical data of 171 AIS patients admitted to Nanhai Hospital of Guangdong Provincial People’s Hospital(“our Hospital”for short)from April 2017 to July 2019 were retrospectively analyzed as study group,and the physical examination data of 61 healthy volunteers who underwent physical examination in our hospital during the same period were retrospectively analyzed as control group.AIS patients were divided into mild,moderate and severe infarction patients according to the area of cerebral infarction,and LP-PLA2 and TCD parameters pulse index(PI),peak systolic flow rate(PSV)and mean blood flow velocity(MV)were compared.LP-PLA2,PI,PSV and MV were compared between the two groups.The influencing factors of poor prognosis in AIS patients were analyzed,and the predictive value of LP-PLA2,PI,PSV and the three on poor prognosis in ASI patients was analyzed.Results LP-PLA2 and PI in the study group were higher than those in the control group,while PSV and MV were lower than those in the control group(P<0.05).LP-PLA2 and PI in severe infarction patients were higher than those in mild and moderate infarction patients(P<0.05),while LP-PLA2 and PI in moderate infarction patients were higher than those in mild infarction patients(P<0.05).PSV and MV in patients with severe infarction were lower than those in patients with mild and moderate infarction(P<0.05),and PSV and MV in patients with moderate infarction were lower than those in patients with mild infarction(P<0.05).The proportion of LP-PLA2,PI and consciousness disorder in poor prognosis was higher than that in good prognosis,while PSV and MV were lower than that in good prognosis(P<0.05).LP-PLA2,PI,PSV and disturbance of consciousness were the influencing factors of poor prognosis in AIS patients(P<0.05).The area under curve values of LP-PLA2,PI,PSV and their combination in AIS patients with poor prognosis were 0.783,0.785,0.744,0.915(P<0.05).Conclusion LP-PLA2,TCD parameters PI,PSV can be used to predict the prognosis of AIS patients.