血栓四项、脂蛋白磷脂酶A2与急性缺血性脑卒中神经功能损伤严重程度的相关性探究

Study on the correlation between four thrombosis factors,lipoprotein phospholipase A2,and the severity of neurological function injury in acute stroke

目的 探讨急性缺血性脑卒中(AIS)患者血清脂蛋白磷脂酶A2(Lp-PLA2)、血栓四项与患者神经功能损伤严重程度的相关性。方法 回顾性分析2022年9月—2023年3月佛山市第二人民医院收治的75例急性AIS患者的临床和实验室资料,依据入院时美国国立卫生院卒中量表(NIHSS)评分将其分为<5分组(n=50)和≥5分组(n=25),比较两组患者一般资料、Lp-PLA2和血栓四项[凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2纤溶酶抑制物复合物(PIC)、血栓调节蛋白(TM)、组织纤溶酶原激活物/纤溶酶原激活物抑制剂-1复合物(tPAI-C)]差异。采用二元Logistic回归分析影响AIS患者入院时NIHSS评分的相关因素,并采用Spearman相关性分析血清LpPLA2、血栓四项和NIHSS评分的相关性。结果 NIHSS评分<5分组患者PIC、TAT、TM以及Lp-PLA2水平均低于≥5分组患者(P<0.05),两组患者tPAI-C比较差异无统计学意义(P>0.05)。二元Logistic回归分析结果显示,TAT和Lp-PLA2是AIS患者NIHSS评分≥5分的独立危险因素(P<0.05)。Spearman相关性分析显示,NIHSS评分与Lp-PLA2(r=0.578)和血栓四项中PIC(r=0.395)、TAT(r=0.403)、TM(r=0.251)均呈正相关(P<0.05),Lp-PLA2与TAT(r=0.349)、PIC(r=0.246)呈正相关(P<0.05)。结论 血栓四项中PIC、TAT、TM和LpPLA2与急性缺血性脑卒中患者神经损伤严重程度有关,Lp-PLA2与PIC、TAT密切相关。

Objective To explore the correlation between serum lipoprotein phospholipase A2(Lp-PLA2),thrombosis and the severity of neurological function damage in patients with acute ischemic stroke(AIS).Methods Retrospective analysis of clinical and laboratory data of 75 patients with acute AIS admitted to Foshan Second People's Hospital from September 2022 to March 2023.Based on the National Institutes of Health Stroke Scale(NIHSS)score at admission,they were divided into<5 group(n=50)and≥5 group(n=25).General information,Lp-PLA2,and thrombus were compared between the two groups,including thrombin antithrombin complex(TAT)and plasmin-αDifferences in plasmin inhibitor complex(PIC),thrombomodulin(TM),tissue plasminogen activator/plasminogen activator inhibitor-1 complex(tPAI-C).Using binary logistic regression analysis to analyze the relevant factors that affect the NIHSS score of AIS patients at admission,and using Spearman correlation analysis to analyze the correlation between serum Lp-PLA2,thrombus,and NIHSS score.Results The levels of PIC,TAT,TM,and Lp-PLA2 in patients with NIHSS scores<5 were significantly lower than those in patients with≥5 group(P<0.05),and there was no significant difference in tPAI-C between the two groups(P>0.05).The results of binary logistic regression analysis showed that TAT and Lp-PLA2 were independent risk factors for AIS patients with a NIHSS score of≥5(P<0.05).Spearman correlation analysis showed that the NIHSS score was positively correlated with Lp-PLA2(r=0.578)and PIC(r=0.395),TAT(r=0.403),and TM(r=0.251)among the four thrombotic factors(P<0.05),while Lp-PLA2 was positively correlated with TAT(r=0.349)and PIC(r=0.246).Conclusion PIC,TAT,TM,and Lp-PLA2 are associated with the severity of neurological damage in patients with acute ischemic stroke,while Lp-PLA2 is closely related to PIC and TAT.