血清脂蛋白相关磷脂酶A2、缺血修饰蛋白及血小板活化因子对缺血性脑卒中病情程度及预后的评估价值  

The Evaluation of Serum Lipoprotein-associated Phospholipase A2,Ischemia Modified Protein and Platelet Activating Factor in the Severity and Prognosis of Ischemic Stroke

作　　者：李岚欣 李波[1] 何强华[1] 苟伟[2] LI Lanxin;LI Bo;HE Qianghua;GOU Wei(Bazhong Central Hospital,Bazhong 636000,Sichuan,China)

机构地区：[1]巴中市中心医院,四川巴中636000 [2]成都市第七人民医院

出　　处：《中西医结合心脑血管病杂志》2020年第23期4061-4064,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的分析血清脂蛋白相关磷脂酶A2(Lp-PLA2)、缺血修饰蛋白(IMA)及血小板活化因子(PAF)对缺血性脑卒中病情监测和预后的评估价值。方法选择巴中市中心医院2018年1月—2019年1月收治的92例缺血性脑卒中病人为缺血性脑卒中组,依据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度组(31例)、中度组(33例),重度组(28例),并依据出院后3个月改良Rankin量表(mRS)分为预后良好组(68例)和预后不良组(24例);另选同期门诊体检的86名健康人员作为对照组。比较各组血清Lp-PLA2、IMA及PAF水平。结果缺血性脑卒中组血清Lp-PLA2、IMA及PAF水平高于对照组(P<0.05)。轻度组血清Lp-PLA2、IMA及PAF水平低于中度组,中度组血清Lp-PLA2、IMA及PAF水平低于重度组(P<0.05)。预后不良组血清Lp-PLA2、IMA及PAF水平高于预后良好组(P<0.05)。ROC曲线分析结果显示,Lp-PLA2、IMA、PAF及Lp-PLA2+IMA+PAF预测缺血性脑卒中预后的曲线下面积分别为0.814、0.888、0.800及0.947,敏感度分别为0.901、0.833、0.911及0.917,特异度分别为0.647、0.823、0.603及0.911。结论缺血性脑卒中病人血清Lp-PLA2、IMA及PAF水平上升,可作为缺血性脑卒中病情监测及预后评价的重要指标。Objective To the evalua serum lipoprotein-associated phospholipase A2(Lp-PLA2),ischemia modified protein(IMA)and platelet activating factor(PAF)in the sererity and prognosis of ischemic stroke.Methods Ninety-two patients with ischemic stroke were divided into mild group(n=31),moderate group(n=33)and severe group(n=28),according to National Institutes of Health Stroke Scale(NIHSS)score.According to modified Rankin scale(mRS)after 3 months,the patients were divided into better prognosis group(n=68)and poor prognosis group(n=24),another 86 healthy persons who underwent outpatient physical examination in the same period were selected as the control group.The levels of serum Lp-PLA2,IMA and PAF in each group were compared.Results The levels of serum Lp-PLA2,IMA and PAF in ischemic stroke group were higher than those in control group(P<0.05).The levels of serum Lp-PLA2,IMA and PAF in mild group were lower than those in moderate group.The levels of serum Lp-PLA2,IMA,PAF,Lp-PLA2+IMA+PAF in moderate group were lower than those in severe group(P<0.05).The levels of serum Lp-PLA2,IMA and PAF in poor prognosis group were lower than those in better prognosis group(P<0.05).According to ROC curve analysis,the areas under the curve of Lp-PLA2,IMA and PAF for predicting the prognosis of ischemic stroke were 0.814,0.888,0.800 and 0.947,the sensitivity was 0.901,0.833,0.911 and 0.917,and the specificity was 0.647,0.823,0.603 and 0.911 tespectively.Conclusion The levels of serum Lp-PLA2,IMA and PAF in patients with ischemic stroke were increased significantly,which could be used as an important indicator for the condition monitoring and prognosis evaluation of ischemic stroke.

关 键 词：缺血性脑卒中 脂蛋白相关磷脂酶A2 缺血修饰蛋白 血小板活化因子 病情程度 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]