CRP、LP(a)及ApoE在急性缺血性脑卒中的表达及临床意义

Expression and clinical significance of CRP,LP(a)and ApoE in acute ischemic stroke

目的分析C反应蛋白(CRP)、脂蛋白a[LP(a)]、载脂蛋白E(ApoE)在急性缺血性脑卒中(AIS)的表达及临床意义。方法收集2019年1月至2021年1月池州市第二人民医院收治的98例AIS患者(AIS组),根据临床神经功能缺损程度评分(NDS)分为轻型(0~15分)49例、中型(16~30分)35例、重型(31~45分)14例;根据Adama分型分为大梗死(累及2个脑解剖部位且病灶直径>30 mm)18例、小梗死(病灶直径15~30 mm)34例、腔隙性梗死(病灶直径<15 mm)46例。另选取本院同期健康体检者98名(对照组)。对比AIS组与对照组以及AIS组中不同病情程度、梗死面积患者CRP、LP(a)及ApoECRP、LP(a)及ApoE水平差异;分析CRP、LP(a)及ApoE与AIS组患者病情严重程度及梗死面积的相关性。结果AIS组CRP、LP(a)及ApoE水平均明显高于对照组,差异有统计学意义(P<0.05);不同病情程度患者CRP、LP(a)及ApoE表达水平:重型>中型>轻型,差异有统计学意义(P<0.05);不同梗死面积患者CRP、LP(a)及ApoE表达水平:大梗死>小梗死>腔隙性梗死,差异有统计学意义(P<0.05);Pearson相关性分析显示:CRP、LP(a)及ApoE与患者病情严重程度及梗死面积之间均为正相关关系(P<0.05)。结论CRP、LP(a)及ApoE在AIS患者中表达均明显上升,通过检测三者水平可为评估病情及梗死面积提供参考依据。

Objective To analyze the expression and clinical significance of C-reactive protein(CRP),lipoprotein a[LP(a)]and ApoE(ApoE)in acute ischemic stroke(AIS).Methods Clinical data of 98 AIS patients admitted to our hospital from January 2019 to January 2021(AIS group)were collected.According to the clinical neurological deficit score(NDS),they were divided into 49 mild(0-15 points),35 moderate(1630 points),and 14 severe(31-45 points)cases;According to Adama's classification,there were 18 cases of large infarction(involving 2 brain anatomical sites and lesion diameter>30 mm),34 cases of small infarction(lesion diameter 15-30 mm),and 46 cases of lacunar infarction(lesion diameter<15 mm).Another 98 healthy subjects(control group)were selected from our hospital during the same period.The differences in CRP,LP(a)and ApoECRP,LP(a)and ApoE levels were compared between the AIS group and the control group,as well as in the AIS group with different disease severity and infarct size,correlation between degree and infarct size.Results The levels of CRP,LP(a)and ApoE in the AIS group were significantly higher than those in the control group,and the difference was statistical significant(P<0.05).The levels of CRP,LP(a)and ApoE in patients with different disease degree and infarct size were statistically significant(P<0.05).The levels of CRP,LP(a)and ApoE in severe patients were higher than those in light and medium patients,and the levels of CRP,LP(a)and ApoE in light patients were the lowest(P<0.05).The levels of CRP,LP(a)and ApoE in patients with large infarction were higher than those in patients with small infarction and lacunar infarction,and the levels of CRP,LP(a)and ApoE in patients with lacunar infarction were the lowest(P<0.05).Pearson correlation analysis showed that CRP,LP(a)and ApoE were positively correlated with patients‘disease severity and infarct size(P<0.05).Conclusion CRP,LP(a)and ApoE are significantly increased in AIS patients,and the detection of these three levels can provide a reference for evaluating the condition and infarct size.