老年急性脑梗死患者血清高残余胆固醇水平与Lp-PLA2表达的相关性研究  

Association of high residual cholesterol levels and Lp-PLA2 expression in elderly patients with acute ischemic stroke

作　　者：林永娟[1] 蒋澄 黄明敏[1] 李玲玲[1] LIN Yong-juan;JIANG Cheng;HUANG Ming-min;LI Ling-ling(Department of Geriatric,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院老年科,江苏南京210008

出　　处：《中华全科医学》2022年第8期1277-1282,共6页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81400965);江苏省干部保健科研课题(BJ18006)。

摘　　要：目的探讨老年急性脑梗死(AIS)患者残余胆固醇(RC)和脂蛋白相关磷脂酶A2(Lp-PLA2)的相关性,评估两者对AIS病情的预测价值。方法选取2019年1月—2021年3月南京大学医学院附属鼓楼医院收治的老年高RC-AIS患者162例(观察组),另外选取同期正常RC-AIS患者165例(对照组),比较2组间血脂指标和Lp-PLA2的差异,采用Pearson法分析相关性,采用ROC曲线评价两者对AIS病情的预测价值。结果观察组Lp-PLA2水平、治疗后美国国立卫生院卒中量表(NIHSS)评分高于对照组(Z=4.361、2.182,均P<0.05)。Logistic回归分析示Lp-PLA2(95%CI:1.000~1.007,P=0.045)、治疗后NIHSS评分(95%CI:1.026~1.369,P=0.021)是AIS患者RC水平的独立影响因素。AIS患者RC、Lp-PLA2水平及治疗后NIHSS评分互呈正相关(r=0.683、0.635、0.640,均P<0.001)。RC>0.845 mmol/L、Lp-PLA2>242 ng/mL预测AIS病情严重程度的ROC曲线下面积分别为0.835、0.854,2项指标联合评估的AUC为0.897。结论高RC-AIS患者血清Lp-PLA2水平显著升高,两者呈正相关,在预测AIS治疗后神经功能缺损程度和预后中具有良好价值。Objective To investigate the correlation between residual cholesterol(RC)and lipoprotein-related phospholipase A2(Lp-PLA2)and evaluated their predictive value in elderly patients with acute ischemic stroke(AIS)and high RC.Methods A total of 162 elderly AIS patients with high RC(observation group)admitted in Nanjing Drum Tower Hospital from Jan.2019 to Mar.2021 were included in the study,and 165 normal RC-AIS patients during the same period were selected as the control group.The levels of blood lipid parameters and Lp-PLA2 in the two groups were compared,and the correlation between RC and Lp-PLA2 were analysed by the Pearson method.ROC analysis was used to evaluate the predictive value of RC and Lp-PLA2 in neurological impairment.Results The levels of Lp-PLA2 and National Institute of Health stroke scale(NIHSS)score after treatment in the observation group were significantly higher than those in the control group(Z=4.361,2.182,all P<0.05).Logistic regression analysis showed that Lp-PLA2(95%CI:1.000-1.007,P=0.045)and NIHSS score after treatment(95%CI:1.026-1.369,P=0.021)were independent factors of RC levels in patients with AIS.RC,Lp-PLA2 and NIHSS score after treatment in patients with AIS were positively correlated with each other(r=0.683,0.635,0.640,all P<0.001).The area under the ROC curve for serum RC>0.845 mmol/L and Lp-PLA2>242 ng/mL in predicting the severity of AIS were 0.835 and 0.854,respectively.When combined with two indicators,the AUC was 0.897.Conclusion Lp-PLA2 levels were significantly increased in patients with high RC-AIS.A positive correlation was found between the levels of RC and Lp-PLA2.High levels of RC or Lp-PLA2 have a good value in predicting the degree of neurological impairment and the prognosis after treatment of patients with AIS.

关 键 词：急性脑梗死 残余胆固醇 脂蛋白相关磷脂酶A2 相关性研究 

分 类 号：R743.33[医药卫生—神经病学与精神病学]