Lp-PLA2、LDL-C、HDL-C、hs-CRP、Hcy及Fib在急性缺血性脑卒中的临床价值  

Clinical value of Lp-PLA2,LDL-C,HDL-C,hs-CRP,Hey and Fib in acute ischemic stroke

作　　者：沈惠敏[1] 黄安延 孔令梅[3] 邱杰明 陈瑞乾 SHEN Huimin;HUANG Anyan;KONG Lingmei;QIU Jieming;CHEN Ruiqian(Department of Neurology,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Psychological Counseling Center,Shantou University Mental Health Center,Shantou 515041,China;Department of Imaging,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Network Center,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515041,China)

机构地区：[1]汕头大学医学院第二附属医院神经内科,广东汕头515041 [2]汕头大学精神卫生中心心理咨询中心,广东汕头515041 [3]汕头大学医学院第二附属医院影像科,广东汕头515041 [4]汕头大学医学院第二附属医院网络中心,广东汕头515041

出　　处：《汕头大学医学院学报》2021年第4期193-199,共7页Journal of Shantou University Medical College

基　　金：广东省医学科学技术研究基金(B2020157,B20211024)。

摘　　要：目的:探讨人血浆脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine,Hcy)和纤维蛋白原(fibrinogen,Fib)对急性缺血性脑卒中(acute ischemic stroke,AIS)患者的临床评估价值。方法:选取2019年6月—2021年6月汕头大学医学院第二附属医院住院的AIS患者80例纳入AIS组,另外选取同期本院80例健康体检者纳入对照组。检测两组及不同梗死面积、不同神经缺损程度患者血清Lp-PLA2、LDL-C、HDL-C、hs-CRP、Hcy及Fib的水平,应用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析以上指标对AIS的临床价值。结果:AIS组患者血清Lp-PLA2[(154.5±30.2)ng/L]、LDL-C[(3.8±0.9)mmol/L]、hs-CRP[(12.6±7.5)mg/L]、Hcy[(16.0±3.5)μmol/L]和Fib[(4.8±1.1)g/L]水平均高于对照组[分别为(128.9±35.9)ng/L、(3.0±0.7)mmol/L、(2.5±2.7)mg/L、(10.6±3.9)μmol/L和(3.8±0.6)g/L],HDL-C[(1.1±0.3)mmol/L]水平低于对照组[(1.3±0.4)mmol/L],上述指标两组比较差异均有统计学意义(均P<0.01),且与患者梗死面积的扩大、神经功能损伤的加重具有相关性。血清Lp-PLA2等6项指标联合检测协助AIS预后分析的ROC曲线下面积为0.950,灵敏度为90.00%,特异度为83.75%。结论:联合检测Lp-PLA2、LDL-C、HDL-C、hs-CRP、Hcy及Fib水平可协同反映AIS的脑组织梗死程度,可作为AIS病情评估的辅助指标。Objective:To investigate the clinical evaluation value of human plasma lipoprotein-associated phospholipase A2(Lp-PLA2),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),high sensitivity C-reactive protein(hs-CRP),homocysteine(Hey)and fibrinogen(Fib)in patients with acute ischemic stroke(AIS).Methods:80 patients with AIS who were hospitalized in the Second Affiliated Hospital of Shantou University Medical College from June 2019 to June 2021 were selected to be included in the AIS group,and another 80 healthy checkups in the same period were selected!to be included in the control group.The levels of serum Lp-PLA2,LDL-C,HDL-C,hs-CRP,Hey and Fib were detected in both groups and in patients with different infarct areas and different degrees of neurological deficits.The clinical value of the above indexes in the diagnosis of AIS was analyzed by receiver operating characteristic curve(ROC curve).Results:The levels of serum Lp-PLA2[(154.5±30.2)ng/L],LDL-C[(3.8±0.9)mmol/L],hs-CRP[(12.6±7.5)mg/L],Hey[(16.0±3.5)μmol/L]and Fib[(4.8±1.1)g/L]were higher in patients in the AIS group than in the control group[(128.9±35.9)ng/L,(3.0±0.7)mmol/L,(2.5±2.7)mg/L,(10.6±3.9)|xmol/L and(3.8±0.6)g/L,respectively]and the level of serum HDL-C[(1.1±0.3)mmol/L]were lower than that of the control group[(1.3±0.4)mmol/L],the differences between the two groups in the above indicators were statistically significant(all PvO.Ol)and correlated with the expansion of the infarct area and the aggravation of neurological injury in patients.The AUC of serum Lp-PLA2 and other six indexes combined to assist in the prognostic analysis of AIS was 0.950,with a sensitivity of 90.00%and a specificity of 83.75%.Conclusion:Combined detection of Lp-PLA2,LDL-C,HDL-C,hs-CRP,Hey and Fib levels can synergistically reflect the degree of cerebral tissue infarction in AIS,and can be used as an auxiliary index for AIS disease assessment.

关 键 词：脂蛋白相关磷脂酶A2 动脉粥样硬化 急性缺血性脑卒中 临床评估 

分 类 号：R743.3[医药卫生—神经病学与精神病学]