RDW、Lp-PLA2水平与急性缺血性脑卒中的相关性研究

Correlation between RDW,Lp-PLA2 levels and acute ischemic stroke

目的探究红细胞分布宽度(RDW)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平与急性缺血性脑卒中(AIS)的相关性。方法回顾性选取2020年1月至2021年6月中南大学湘雅医学院附属海口医院收治的120例疑似AIS患者作为研究对象,以患者是否确诊为AIS分为AIS组(n=78)和非AIS组(n=42),再将AIS组按照病情严重程度分为轻度组(n=30)、中度组(n=25)和重度组(n=23)。收集所有疑似AIS患者一般资料及生化指标水平。采用单因素分析相关指标和AIS的关系,采用Pearson相关系数法分析Lp-PLA2、RDW与AIS病情严重程度的相关性。采用受试者工作特征曲线(ROC)分析Lp-PLA2、RDW及其联合对AIS的诊断价值。结果AIS组合并高血压、高血脂患者占比及白细胞计数(WBC)、甘油三酯、低密度脂蛋白(LDL)、同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)、Lp-PLA2、RDW水平均明显高于非AIS组,差异均有统计学意义(P<0.05)。轻度组、中度组、重度组患者的血清Lp-PLA2、RDW水平均依次增高,差异均有统计学意义(P<0.05)。血清Lp-PLA2、RDW与AIS患者NIHSS评分均呈线性正相关(r=0.800、0.782,P<0.05)。ROC曲线分析显示,血清Lp-PLA2、RDW及二者联合诊断AIS的曲线下面积(AUC)分别为0.676、0.876、0.961,以二者联合的诊断价值最高(敏感度为87.18%、特异度为92.86%)。结论Lp-PLA2、RDW与AIS病情进展密切相关,均可用作AIS患者诊断和病情严重程度评估的辅助指标,且以Lp-PLA2联合RDW的诊断效能最大。

Objective To investigate the correlation between red blood cell distribution width(RDW),lipoprotein-associated phospholipase A2(Lp-PLA2)levels and acute ischemic stroke(AIS).Methods A total of 120 suspected AIS patients admitted to our hospital from January 2020 to June 2021 were retrospectively selected as the research objects.The patients diagnosed as AIS were divided into AIS group(n=78)and non-AS group(n=42),and then the AIS group was divided into mild group(n=30),moderate group(n=25)and severe group(n=23)according to the severity of the disease.The general data and biochemical indexes of all patients were collected.The correlation between Lp-PLA2,RDW and the severity of AIS was analyzed by Pearson correlation coefficient.The diagnostic value of Lp-PLA2,RDW and their combination for AIS was analyzed by receiver operating characteristic curve(ROC).Results The proportion of patients with hypertension and hyperlipidemia in AIS group and the levels of white blood cell count(WBC),triglyceride(TG),low-density lipoprotein(LDL),homocysteine(Hcy),high-sensitivity C-reactive protein(hs-CRP),Lp-PLA2 and RDW were significantly higher than those in the non-AS group,the differences were statistically significant(P<0.05).The serum Lp-PLA2 and RDW levels in the mild group,the moderate group and the severe group were increased in tur,the differences were statistically significant(P<0.05).Serum Lp-PLA2 and RDW were positively correlated with NIHSS scores of AIS patients(r=0.800 and 0.782,P<0.05).ROC curve analysis showed that the area under the curve(AUC)of serum Lp-PLA2,RDW and their combination in the diagnosis of AIS were 0.676,0.876 and 0.961,respectively,and the combination had the highest diagnostic value(sensitivity was 87.18%,specificity was 92.86%).Conclusion Lp-PLA2 and RDW are closely related to the progression of AIS,which can be used as auxiliary indicators for the diagnosis and severity assessment of AIS patients,and Lp-PLA2 combined with RDW has the highest diagnostic efficiency.