急性缺血性脑梗死患者血清LP-PLA2水平表达对颈动脉斑块新生血管分级的影响  

Effect of serum Lp-PLA2 expression on neovascularization grade of carotid plaque in patients with acute ischemic cerebral infarction

作　　者：戴轶伟[1] 季燕[1] 成云芳[1] DAI Yiwei;JI Yan;CHENG Yunfang(Department of Neurology,Nantong Third People's Hospital,Nantong Jiangsu 226000,China)

机构地区：[1]南通市第三人民医院神经内科,江苏南通226000

出　　处：《中国急救复苏与灾害医学杂志》2023年第3期316-319,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省自然科学基金青年基金项目(编号:BK20170447)。

摘　　要：目的探究急性缺血性脑梗死患者血清脂蛋白相关磷脂酶A2(LP-PLA2)水平表达对颈动脉斑块新生血管分级的影响。方法选取南通市第三人民医院2018年7月—2021年11月收治的96例急性缺血性脑梗死患者作为研究对象,收集并整理患者基础病历资料,超声造影评估新生血管分级,酶联免疫吸附试验测定血清LPPLA2水平,根据患者入院3个月后预后情况将其分为预后良好组和预后不佳组。Spearman相关性分析法分析急性缺血性脑梗死患者颈动脉斑块新生血管分级与血清LP-PLA2水平相关性。结果96例急性缺血性脑梗死患者中预后良好51例(53.12%),45例(46.88%)预后不佳。预后良好组血清LP-PLA2低于预后不佳组(P<0.05);两组新生血管分级比较差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,心房颤动、心脏瓣膜病、入院时美国国立卫生院卒中量表(NIHSS)评分偏高、新生血管分级及血清LP-PLA2表达水平升高均为急性缺血性脑梗死预后的危险因素(P<0.05)。Spearman相关性分析结果显示,新生血管分级与血清LP-PLA2水平呈正相关(r=0.812,P<0.05)。结论预后不佳组急性缺血性脑梗死患者新生血管分级与血清LP-PLA2表达水平高于预后良好组,且新生血管分级与血清LP-PLA2水平呈正相关。Objective To investigate the effect of serum lipoprotein associated phospholipase A2(Lp-PLA2)level expression on the neovascular grade of carotid plaque in patients with acute ischemic cerebral infarction.Methods Neovascularization in carotid plaque was detected and graded by contrast-enhanced ultrasound in 96 patients with acute cerebral infarction.Peripheral fasting venous blood samples were collected to determine the serum level of LPPLA2 by ELISA.Relevant medical data were surveyed.All patients were followed for 3 months and divided into 2 groups:poor prognosis group(dead or with disability,n=45)and good prognosis group(medically stable or on the mend,n=51,53.12%).Spearman correlation analysis was used to analyse the relation between the serum Lp-PLA2 level and neovascularization grade of carotid plaque.Results After 3-months follow-up,51 of the 96 patients(53.12%),were classified into the good prognosis group,and 45 cases(46.88%)were classified into poor prognosis group.The serum Lp-PLA2 level of the good prognosis group was significantly lower than that of the poor prognosis group(P<0.05).The proportions of atrial fibrillation and valvular diseases,and the NIHSS score of the good prognosis group were all significantly lower than those of the poor prognosis gfroup(all P<0.05).Logistic multivariate analysis showed that atrial fibrillation,valvular heart disease,high NIHSS score at admission,neovascular grade and elevated serum Lp-PLA2 expression were all risk factors for the prognosis of acute ischemic cerebral infarction(P<0.05).Spearman correlation analysi sshowed that the grade of neovascularization was positively correlated with the level of serum Lp-PLA2(r=0.812,P<0.05).Conclusion The grade of neovascularization and the expression level of serum LP-PLA2 in patients with acute ischemic cerebral infarction with poor prognosis are higher than those in the patients with good prognosis group,and the grade of neovascularization is positively correlated with the level of serum LP-PLA2.

关 键 词：急性缺血性脑梗死 颈动脉斑块新生血管分级 脂蛋白相关磷脂酶A2 相关性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]