大动脉粥样硬化型脑梗死患者外周血sCD40L、LP(a)、Lp-PLA2水平与神经缺损程度的相关性及其诊断意义

The correlation between the levels of peripheral blood sCD40L,LP(a),Lp-PLA2 and the degree of nerve defect in patients with large atherosclerotic cerebral infarction and its diagnostic significance

目的:探讨大动脉粥样硬化型脑梗死(LAACI)患者外周血可溶性CD40配体(sCD40L)、脂蛋白a[LP(a)]、脂蛋白相关磷脂酶A2(Lp-PLA2)水平与神经缺损程度的相关性及其诊断意义。方法:回顾性分析上海市宝山区罗店医院2020年8月—2022年8月收治的122例LAACI患者(观察组)临床资料,以108例同期健康体检者作为健康对照组,比较两组外周血sCD40L、LP(a)、Lp-PLA2水平;依据美国国立卫生研究院卒中量表评分对观察组患者神经功能缺损程度进行分型,比较轻型、中型、重型患者外周血sCD40L、LP(a)、Lp-PLA2水平差异;采用Pearson相关性分析方法分析LAACI患者神经功能缺损程度与外周血sCD40L、LP(a)、Lp-PLA2水平之间的关系。结果:(1)观察组患者sCD40L、LP(a)及Lp-PLA2水平高于健康对照组(P <0.05);(2)重型患者sCD40L、LP(a)及Lp-PLA2水平高于轻型与中型患者,神经功能缺损程度越轻,sCD40L、LP(a)及Lp-PLA2水平越低(P <0.05);(3)外周血sCD40L、LP(a)及Lp-PLA2水平与神经功能损伤程度均表现为显著正相关(r_(sCD40L)=0.779,r(LP(a))=0.982,rLp-PLA2=0.505;P <0.05)。结论:LAACI患者外周血sCD40L、LP(a)、Lp-PLA2水平升高,并与其神经功能缺损程度呈正相关,能够作为临床诊断该类疾病的有效依据。

Objective:To explore the correlation between soluble CD40 ligand(sCD40L),lipoprotein a[LP(a)]and lipoprotein related phospholipase A2(Lp-PLA2)in peripheral blood and the degree of nerve defect in patients with large artery atherosclerotic cerebral infarction(LAACI)and its diagnostic significance.Methods:The clinical data of 122 patients with LAACI(observation group)admitted to Shanghai Baoshan Luodian Hospital from Aug.2020 to Aug.2022 were retrospectively analyzed.Another 108 patients who underwent physical examination in the hospital during the same period were selected as the healthy control group.The levels of sCD40L,LP(a),and Lp-PLA2 in peripheral blood were compared between the two groups.According to the score of National Institute of Health stroke scale,the neurological impairment degree of the observation group was classified.Then the levels of sCD40L,LP(a),Lp-PLA2 in peripheral blood of mild,medium,and severe patients were compared.Pearson correlation analysis was used to analyze the relationship between the levels of sCD40L,LP(a)and Lp-PLA2 in peripheral blood and the degree of neurological impairment in LAACI patients.Results:aThe levels of sCD40L,LP(a)and Lp-PLA2 in the observation group were higher than those in the healthy control group(P<0.05).bThe levels of sCD40L,LP(a)and Lp-PLA2 in severe patients were higher than those in mild and medium patients,and the degree of neurological deficit the lighter,the lower the levels of sCD40L,LP(a)and Lp-PLA2.The milder neurological function impaired,the lower levels of sCD40L,LP(a)and Lp-PLA2 could be(P<0.05).cThe levels of sCD40L,LP(a)and Lp-PLA2 in peripheral blood were significantly positively correlated with the degree of neurological damage(r_(sCD40L)=0.779,rLP(a)=0.982,rLp-PLA2=0.505,P<0.05).Conclusions:The levels of sCD40L,LP(a),and Lp-PLA2 in peripheral blood of LAACI patients are increased,and they are closely related to the degree of neurological impairment, which can be used as an effective basis for clinical diagnosis of this disease.