老年H型高血压伴急性脑梗死患者TyG、LP-PLA2水平检测及临床意义

Detection and clinical significance of triglyceride glucose index and LP-PLA2 levelin elderly patients with H-type hypertension and acute cerebral infarction

目的探讨老年H型高血压伴急性脑梗死(acute cerebral infarction,ACI)患者三酰甘油葡萄糖指数(triglyceride glucose,TyG)、血脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LP-PLA2)水平检测及临床意义。方法回顾性分析老年H型高血压伴ACI患者(研究组)97例、老年H型高血压患者(对照组)148例。比较2组临床资料及TyG、LP-PLA2水平。依据脑梗死面积将老年H型高血压伴ACI患者分为轻度梗死组(31例)、中度梗死组(42例)及重度梗死组(24例)3个亚组,比较不同梗死程度老年H型高血压伴ACI患者TyG、LP-PLA2水平。Pearson相关性分析TyG、LP-PLA2水平与脑梗死体积的关系。Logistic多因素回归分析确定老年H型高血压患者发生ACI的影响因素。结果研究组高血压2/3级占比、收缩压、舒张压、低密度脂蛋白胆固醇、同型半胱氨酸(homocysteine,Hcy)、TyG、LP-PLA2水平高于对照组(P<0.05)。中度梗死组和重度梗死组患者TyG(7.46±1.28、8.15±1.32)、LP-PLA2[(197.85±38.62)μg/L、(229.74±47.51)μg/L]水平高于轻度梗死组(6.83±1.15)μg/L、(175.68±34.59)μg/L;重度梗死组患者TyG、LP-PLA2水平高于中度梗死组(P<0.05)。老年H型高血压伴ACI患者TyG、LP-PLA2水平与脑梗死体积均呈正相关(r=0.547、0.623,P=0.026、0.018)。多因素分析结果显示,高血压(OR=2.912,95%CI:1.728~4.908)、Hcy(OR=2.959,95%CI:1.756~4.987)、TyG(OR=3.114,95%CI:1.848~5.248)、LP-PLA2(OR=3.364,95%CI:1.996~5.668)均为老年H型高血压患者发生ACI的相关影响因素(P<0.05)。结论老年H型高血压患者ACI患者TyG、LP-PLA2水平升高,TyG、LP-PLA2与老年H型高血压患者发生ACI密切相关。

Objective To investigate the triglyceride glucose(TyG)index and lipoprotein-associated phospholipase A2(LP-PLA2)levels and their clinical significance in elderly patients with H-type hypertension and acute cerebral infarction(ACI).Methods A total of 97 elderly patients with H-type hypertension complicated with ACI(research group)and 148 elderly patients with H-type hypertension(control group)were retrospectively analyzed.The clinical data,and TyG and LP-PLA2 levels were compared between the two groups.According to the area of cerebral infarction,the elderly patients with H-type hypertension and ACI were divided into three subgroups:mild infarction group(n=31),moderate infarction group(n=42)and severe infarction group(n=24).The levels of TyG and LP-PLA2 in elderly patients with H-type hypertension and different degrees of ACI were compared.Pearson correlation analysis was used to analyze the relationship between TyG,LP-PLA2 levels and cerebral infarction volume.Multivariate Logistic regression analysis was used to determine the influencing factors of ACI in elderly patients with H-type hypertension.Results The proportion of grade 2/3 hypertension,systolic blood pressure,diastolic blood pressure,low-density lipoprotein cholesterol,homocysteine(Hcy),TyG,and LP-PLA2 levels in the research group were higher than those in the control group(P<0.05).The levels of TyG(7.46±1.28,8.15±1.32)and LP-PLA2[(197.85±38.62)μg/L,(229.74±47.51)μg/L]in moderate infarction group and severe infarction group were higher than those in mild infarction group[(6.83±1.15)μg/L and(175.68±34.59)μg/L].The levels of TyG and LP-PLA2 in the severe infarction group were higher than those in the moderate infarction group(P<0.05).TyG and LP-PLA2 levels were positively correlated with cerebral infarction volume in elderly patients with H-type hypertension and ACI(r=0.547 and 0.623,P=0.026 and 0.018).Multivariate analysis showed that hypertension(OR=2.912,95%CI:1.728-4.908),Hcy(OR=2.959,95%CI:1.756-4.987),TyG(OR=3.114,95%CI:1.848-5.248)and LP-PLA2(OR=3.364,95%CI:1.996-5.668)were all related influencing factors for ACI in elderly patients with H-type hypertension(P<0.05).Conclusion TyG and LP-PLA2 levels are increased in elderly patients with H-type hypertension and ACI.TyG and LP-PLA2 are closely related to ACI in elderly patients with H-type hypertension.