进展性脑梗死患者炎性因子、血浆Lp-PLA2水平变化及其临床意义

Changes and clinical significance of inflammatory factors and plasma Lp-PLA2 levels in patients with progressive cerebral infarction.

目的检测进展性脑梗死患者的炎性因子和血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平,并探讨其临床意义。方法选取2019年5月至2020年5月铜川市人民医院神经内科收治的45例进展性脑梗死患者作为进展组,并选择本院同期收治的55例非进展性脑梗死患者作为非进展组。比较两组患者发病后1 d、3 d、7 d、14 d时的美国国立卫生院神经功能缺损评分(NIHSS)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、Lp-PLA2水平,并采用Pearson相关性分析法分析TNF-α、IL-6、Lp-PLA2和NIHSS评分的相关性。结果进展组患者发病后3 d、7 d、14 d时NIHSS评分分别为(27.31±2.42)分、(28.01±2.55)分、(26.14±2.07)分,明显高于非进展组的(23.07±2.15)分、(21.83±2.04)分、(18.26±2.13)分,差异均有统计学意义(P<0.05);发病后3 d、7 d、14 d时,进展组患者的TNF-α水平分别为(2.70±0.23)pg/mL、(2.63±0.17)pg/mL、(2.42±0.11)pg/mL,明显高于非进展组的(1.36±0.11)pg/mL、(1.10±0.12)pg/mL、(1.03±0.15)pg/mL,IL-6水平分别为(342.46±28.51)pg/mL、(337.62±25.40)pg/mL、(326.27±21.53)pg/mL,明显高于非进展组的(231.01±19.73)pg/mL、(187.36±22.18)pg/mL、(161.81±19.24)pg/mL,血浆Lp-PLA2水平分别为(33.02±2.75)μg/L、(30.16±2.42)μg/L、(27.25±2.77)μg/L,明显高于非进展组的(14.06±2.13)μg/L、(12.71±2.02)μg/L、(9.52±1.68)μg/L,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,TNF-α、IL-6、Lp-PLA2和NIHSS评分均呈正相关(r=0.388、0.413、0.455,P<0.05)。结论进展性脑梗死患者炎性因子TNF-α、IL-6、血浆Lp-PLA2水平明显升高,且与患者神经功能缺损程度密切相关,可能是导致疾病发生的重要危险因素,具有较好的临床应用价值。

Objective To detect the levels of inflammatory factors and plasma lipoprotein-associated phospholipase A2(LP-PLA2)in patients with progressive cerebral infarction,and discuss its clinical significance.Methods Forty-five patients with progressive cerebral infarction treated in Department of Neurology,Tongchuan People's Hospital from May 2019 to May 2020 were selected as the progressive group,and 55 patients with non-progressive cerebral infarction treated in the hospital during the same period were selected as the non-progressive group.Neurological deficit score(National Institutes of Health Stroke Scale,NIHSS),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and Lp-PLA2 levels at 1 d,3 d,7 d,and 14 d after the onset were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between TNF-α,IL-6,LP-PLA2 and NIHSS score.Results The NIHSS scores at 3 d,7 d,and 14 d after the onset in the progressive group were(27.31±2.42)points,(28.01±2.55)points,and(26.14±2.07)points,which were significantly higher than(23.07±2.15)points,(21.83±2.04)points,and(18.26±2.13)points in non-progressive group(P<0.05).At 3 d,7 d,and 4 d after the onset,the TNF-αlevels in the progressive group were(2.70±0.23)pg/mL,(2.63±0.17)pg/mL,and(2.42±0.11)pg/mL,which were significantly higher than(1.36±0.11)pg/mL,(1.10±0.12)pg/mL,(1.03±0.15)pg/mL in non-progressive group;the IL-6 levels were(342.46±28.51)pg/mL,(337.62±25.40)pg/mL,(326.27±21.53)pg/mL,which were significantly higher than(231.01±19.73)pg/mL,(187.36±22.18)pg/mL,(161.81±19.24)pg/mL in non-progressive group;the plasma LP-PLA2 levels were(33.02±2.75)μg/L,(30.16±2.42)μg/L,and(27.25±2.77)μg/L,which were significantly higher than(14.06±2.13)μg/L,(12.71±2.02)μg/L,(9.52±1.68)μg/L in non-progressive group;the differences were statistically significant(P<0.05).Pearson correlation analysis showed that TNF-α,IL-6,LP-PLA2 were positively correlated with NIHSS scores(r=0.388,0.413,0.455,P<0.05).Conclusion The inflammatory factors TNF-α,IL-6,and plasma LP-PLA2 levels are significantly increased in patients with progressive cerebral infarction,and are closely related to the degree of neurological impairment in patients,which may be an important risk factor leading to the occurrence of disease and have good clinical application value.