Lp-PLA2、HDAC3、TAFI水平对大面积半球脑梗死患者预后的评估价值

Prognostic roles of Lp-PLA2,HDAC3 and TAFI levels in patients with large-scale cerebral infarction

目的探究脂蛋白相关磷脂酶A2(Lp-PLA2)、组蛋白脱乙酰酶(HDAC)3、凝血酶活化纤维蛋白溶解抑制物(TAFI)在大面积半球脑梗死患者预后评估中的价值。方法选取2020年3月—2023年3月河南科技大学附属黄河医院120例大面积半球脑梗死患者(大面积半球脑梗死组),另选取同期120名体检健康者(正常对照组)。采用酶联免疫吸附试验检测所有研究对象Lp-PLA2、HDAC3、TAFI水平。对所有大面积半球脑梗死患者进行90 d的随访,其中预后不良组45例、预后良好组75例。采用Spearman相关分析评价Lp-PLA2、HDAC3、TAFI水平与美国国立卫生研究院卒中量表(NIHSS)评分的关系。采用受试者工作特征(ROC)曲线评估Lp-PLA2、HDAC3、TAFI判断大面积半球脑梗死患者预后的效能。采用多因素Logistic回归分析评估大面积半球脑梗死患者预后不良的影响因素。结果与正常对照组比较,大面积半球脑梗死组Lp-PLA2、HDAC3、TAFI水平显著升高(P<0.001)。大面积半球脑梗死患者Lp-PLA2、HDAC3、TAFI水平与NIHSS评分呈正相关(r_(s)值分别为0.542、0.620、0.597,P<0.05)。与预后良好组比较,预后不良组NIHSS评分、Lp-PLA2、HDAC3、TAFI水平显著升高(P<0.001)。NIHSS评分、Lp-PLA2、HDAC3、TAFI是大面积半球脑梗死患者预后不良的危险因素(P<0.01)。Lp-PLA2、HDAC3、TAFI和NIHSS评分单项检测和联合检测判断大面积半球脑梗死患者预后不良的曲线下面积(AUC)分别为0.790、0.795、0.780、0.908和0.964。结论大面积半球脑梗死患者Lp-PLA2、HDAC3、TAFI水平显著升高,Lp-PLA2、HDAC3、TAFI和NIHSS评分联合检测对大面积半球脑梗死患者预后评估有较高的价值。

Objective To evaluate the prognostic roles of lipoprotein-associated phospholipase A2(Lp-PLA2),histone deacetylase(HDAC)3 and thrombin activable fibrinolysis inhibitor(TAFI)levels in patients with large-scale cerebral infarction.Methods A total of 120 patients with large-scale cerebral infarction in Henan University of Science and Technology Affiliated Yellow River Hospital from March 2020 to March 2023 were enrolled as large-scale cerebral infarction group,and 120 healthy subjects during the same period were enrolled as control group.Lp-PLA2,HDAC3 and TAFI levels were determined by enzyme-linked immunosorbent assay.All the patients with large-scale cerebral infarction were followed up for 90 d,which included 45 patients with poor prognosis and 75 patients with good prognosis.Spearman correlation analysis was used to evaluate the relationship between Lp-PLA2,HDAC3,TAFI levels and the National Institute of Health Stroke Scale(NIHSS)score.The prognostic roles of Lp-PLA2,HDAC3 and TAFI levels in patients with large-scale cerebral infarction was analyzed by receiver operating characteristic(ROC)curve.Multivariate Logistic regression analysis was used to evaluate the factors affecting the poor prognosis of patients with large-scale cerebral infarction.Results Compared with control group,Lp-PLA2,HDAC3 and TAFI levels in large-scale cerebral infarction group were increased(P<0.001).Lp-PLA2,HDAC3 and TAFI levels were positively correlated with NIHSS score in patients with large-scale cerebral infarction(r_(s)=0.542,0.620 and 0.597,P<0.05).Compared with good prognosis group,NIHSS score,Lp-PLA2,HDAC3 and TAFI levels in poor prognosis group were increased(P<0.001).NIHSS score,Lp-PLA2,HDAC3 and TAFI levels were the factors for poor prognosis in patients with large-scale cerebral infarction(P<0.01).The areas under curves of Lp-PLA2,HDAC3,TAFI and NIHSS score single determinations and combined determination were 0.790,0.795,0.780,0.908 and 0.964,respectively.Conclusions Lp-PLA2,HDAC3 and TAFI in patients with large-scale cerebral infarction are increased,and the Lp-PLA2,HDAC3,TAFI and NIHSS score combined determination is of certain value in evaluating the prognosis of patients with large-scale cerebral infarction.