首发缺血性脑卒中患者血清脂蛋白磷脂酶A_(2)低氧诱导因子1α及同型半胱氨酸水平变化及意义  

To investigate the changes and significance of level of serum Lp-PLA2,HIF-1αand Hcy in patients with first-episode ischemic stroke

作　　者：何芸[1] 刘波[2] He Yun;Liu Bo(Department of Internal Medicine-Neurology,Ankang Central Hospital,Shaanxi 725000,China;不详)

机构地区：[1]陕西省安康市中心医院神经内科,725000 [2]陕西省安康市中医医院检验科

出　　处：《山西医药杂志》2021年第19期2745-2748,共4页Shanxi Medical Journal

摘　　要：目的探讨首发缺血性脑卒中患者血清脂蛋白磷脂酶A_(2)(Lp-PLA2)、同型半胱氨酸(Hcy)及低氧诱导因子1α(HIF-1α)水平变化及意义。方法选取2019年1月至2020年8月我院收治的首发缺血性脑卒中患者90例作为研究对象,设为观察组,同期选择在我院体检的健康人群35名设为对照组,比较2组受试者的临床资料及Lp-PLA2、Hcy、HIF-1α等血清指标,应用多因素Logistic回归分析首发缺血性脑卒中发病的危险因素,应用ROC曲线分析危险因素在缺血性脑卒中患者诊治中的价值。结果观察组的血清白细胞介素(IL)-6、IL-8、降钙素原(PCT)、WBC、Lp-PLA2、Hcy及HIF-1α水平均明显高于对照组,差异有统计学意义(P<0.05);Logistic回归分析显示,血清Lp-PLA2、Hcy及HIF-1α水平均为缺血性脑卒中发生的独立危险因素(P<0.05);发病后随访3个月,预后不良组患者的血清Lp-PLA2、Hcy及HIF-1α水平均明显高于预后良好组,差异有统计学意义(P<0.05);ROC曲线提示,3项指标联合检测的AUC下面积明显大于Lp-PLA2、Hcy及HIF-1α水平,联合检测的灵敏度、特异度均优于单独检测(P<0.05)。结论首发缺血性脑卒中患者血清Lp-PLA2、Hcy及HIF-1α水平异常升高,提示其参与了缺血性脑卒中的发生、进展,可作为首发缺血性脑卒中的生化标记物,三项联合检测可提高诊断效能。Objective To investigate the changes and significance of serum lipoprotein phospholipase A_(2)(Lp-PLA2),homocysteine(Hcy)and hypoxia-inducible factor(HIF)1αlevels in patients with first ischemic stroke.Methods Ninety patients with first-onset ischemic stroke admitted to our hospital from January 2019 to August 2020 were selected as the study object and set as the observation group.Thirty-five healthy examinees during the same period in our hospital were selected as the control group.The clinical data of the subjects in the two groups and serum indicators such as Lp-PLA2,Hcy,and HIF-1αwere used to analyze the risk factors of first-onset ischemic stroke by using multivariate Logistic regression,and the ROC curve was used to analyze the risk factors in diagnosis and treatment of patients with ischemic stroke.Results The levels of serum interleukin(IL)-6,IL-8,procalcitonin(PCT),white blood cell(WBC),Lp-PLA2,Hcy and HIF-1αin the observation group were significantly higher than those in the control group(P<0.05).Logistic regression analysis showed that serum Lp-PLA2,Hcy and HIF-1αlevels were independent risk factors for ischemic stroke(P<0.05).After 3 months of follow-up,the serum levels of Lp-PLA2,Hcy and HIF-1αin patients with poor prognosis were significantly higher than those in the prognosis group(P<0.05).The ROC curve suggested that the area under the AUC combinedly deteted by the three indicators was significantly larger than that of Lp-PLA2,Hcy and HIF-1α.The sensitivity and specificity of the combined detection were better than those of the single detection(P<0.05).Conclusion The levels of serum Lp-PLA2,Hcy and HIF-1αin patients with first-onset ischemic stroke were abnormally elevated,suggesting that they were involved in the occurrence and progression of ischemic stroke,and can be used as biochemical markers for the first-onset ischemic stroke.The combination of three tests can improve the diagnostic efficiency.

关 键 词：卒中 磷脂酶A_(2) 氧诱导因子1 α亚基 危险因素 预后 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]