脂蛋白相关磷脂酶A2与卒中后认知功能障碍的关系研究

Association of lipoprotein-associated phospholipase A2 with post stroke cognitive impairment in patients with stroke

目的研究血清脂蛋白相关磷脂酶A2(Lp-PLA2)与卒中后认知功能障碍(PSCI)的相关性。方法选择2019年8月至2021年6月淮安市第一人民医院神经内科住院的缺血性卒中患者186例,随访半年,根据是否发生PSCI分为观察组(PSCI患者38例)和对照组(认知功能正常患者148例)。收集两组患者的一般资料,行神经功能评估及生化指标检查。采取双向法进行多因素logistic回归分析发生PSCI的危险因素,采用Spearman秩相关分析血清Lp-PLA2与蒙特利尔认知评估量表(MoCA)评分的相关性,采用ROC曲线分析缺血性卒中后发生PSCI时Lp-PLA2的截断值。结果观察组血清Lp-PLA2水平高于对照组,差异有统计学意义(P<0.01)。同型半胱氨酸(Hcy)、β2微球蛋白、Lp-PLA2与MoCA均呈负相关(r=-0.28、-0.15、-0.49,均P<0.01)。Lp-PLA2的AUC为0.849,缺血性卒中后发生PSCI时Lp-PLA2的截断值为232 ng/ml。结论血清Lp-PLA2水平升高是发生PSCI的独立危险因素,可考虑作为缺血性卒中后发生PSCI的生物标志物。

Objective To study the association of serum lipoprotein associated phospholipase A2(Lp-PLA2)and post stroke cognitive impairment(PSCI).Methods A total of 186 patients with ischemic stroke hospitalized in the department of neurology of Huai'an First People's Hospital from August 2019 to June 2021 were selected,followed up for half a year,and divided into observation group(38 PSCI cases)and control group(148 cognitively normal cases)according to whether PSCI occurred.General data of two groups of patients were collected,neurological function assessment and biochemical index examination were performed.Multivariate logistic regression analysis was carried out by bidirectional method to analyze the risk factors of PSCI,Spearman rank correlation was used to analyze the correlation between serum Lp-PLA2 and Montreal Cognitive Assessment Scale(MoCA)score,and ROC curve was used to analyze the cut-off value of Lp-PLA2 when PSCI occurred after ischemic stroke.Results Serum Lp-PLA2 level in observation group was significantly higher than that in control group,the difference was statistically significant(P<0.01).Hcy、Beta-2 microglobulin、Lp-PLA2 level was significantly correlated with MoCA scores(r=-0.28、-0.15、-0.49,all P<0.01).The AUC of Lp-PLA2 is 0.849,and the cut-off value for PSCI after ischemic stroke was 232ng/ml.Conclusion Elevated serum LPPLA2 is an independent risk factor for PSCI,and may be used as a biomarker for cognitive dysfunction in patients after ischemic stroke.