急性缺血性脑卒中患者IMA、Lp-PLA2、sdLDL-C水平及与脑侧支循环分级的相关性研究

Correlations between IMA,Lp-PLA2,sdLDL-C levels and grading of cerebral collateral circulation in patients with acute ischemic stroke

目的探讨血清缺血修饰蛋白(IMA)、脂蛋白相关磷脂酶A2(Lp-PLA2)、小而密低密度脂蛋白胆固醇(sdLDL-C)在急性缺血性脑卒中患者中的表达,并分析3项指标与脑侧支循环分级的关系。方法收集2018年1月至2020年12月在陕西省延安市人民医院就诊的100例急性缺血性脑卒中患者作为研究组,并根据脑侧支循环分级情况分为一级33例、二级48例,三级19例。同期收集体检中心体检健康者100例作为对照组。比较两组研究对象的血清IMA、Lp-PLA2、sdLDL-C水平,分析不同分级急性缺血性脑卒中患者血清IMA、Lp-PLA2、sdLDL-C水平,并采用Logistic回归分析3项指标对脑侧支循环分级的影响。结果研究组血清IMA、Lp-PLA2、sdLDL-C水平明显高于对照组,差异有统计学意义(P<0.05)。不同脑侧支循环分级患者血清IMA、Lp-PLA2、sdLDL-C水平比较,差异有统计学意义(P<0.05),且随分级升高,3项指标逐渐升高。IMA、Lp-PLA2、sdLDL-C均为急性缺血性脑卒中患者脑侧支循环分级的影响因素(P<0.05)。结论急性缺血性脑卒中患者IMA、Lp-PLA2、sdLDL-C水平明显升高,且与脑侧支循环分级关系密切。

Objective To investigate the expression of isakia-modified protein(IMA),lipoprotein-associated phospholiopase A2(Lp-PLA2),small and dense low density lipoprotein cholesterol(sdLDL-C)in patients with acute ischemic stroke,to analyze the correlations between the three indicators expressions and the grading of cerebral collateral circulation.Methods A total of 100 patients with acute ischemic stroke who were admitted to Yan'an People's Hospital from January 2018 to December 2020 were collected as the study group.According to the grading of cerebral collateral circulation,33 patients were divided into gradeⅠ,48 patients were in gradeⅡ,19 patients were in gradeⅢ.A total of 100 healthy subjects were collected as the control group.The levels of IMA,Lp-PLA2 and sdLDL-C in the two groups were compared,the levels of IMA,Lp-PLA2 and sdLDL-C in the acute ischemic stroke patients with different cerebral collateral circulation grades were analyzed.Logistic regression was used to analyze the effects of the three indexes on grading of cerebral collateral circulation.Results The levels of IMA,Lp-PLA2 and sdLDL-C in study group were significantly higher than those in control group,the differences were statistically significant(P<0.05).There were statistically significant differences on serum IMA,Lp-PLA2 and sdLDL-C levels among different cerebral collateral circulation grading patients(P<0.05),the three indexes gradually increased with the increase of grading.IMA,Lp-PLA2 and sdLDL-C were all influential factors of cerebral collateral circulation grading in patients with acute ischemic stroke(P<0.05).Conclusion The levels of IMA,Lp-PLA2 and sdLDL-C significantly increase in patients with acute ischemic stroke,which relate closely to the grading of cerebral collateral circulation.