急性脑梗死患者不同性质颈动脉粥样斑块及预后的sdLDL-C、Lp-PLA2水平观察  

in patients with acute cerebral infarction with differentproperties of carotid atheromatous plaques and prognosis

作　　者：徐斐[1] 徐晓杰[2] 李瑞[3] XU Fei;XU Xiaojie;LI Rui(Department of Clinical Laboratory,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Department of Clinical Laboratory,The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;Department of Radiology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院检验科,浙江温州325000 [2]温州医科大学附属第二医院检验科,浙江温州325000 [3]温州医科大学附属第一医院放射科,浙江温州325000

出　　处：《健康研究》2024年第1期108-112,共5页Health Research

基　　金：温州市科技局基础性科研项目(Y20210737)。

摘　　要：目的 观察急性脑梗死(ACI)患者的小而密低密度脂蛋白胆固醇(sdLDL-C)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平,探讨其与颈动脉粥样斑块稳定性的关系,以期为早期识别和改善患者预后提供思路。方法 依据颈部血管超声检查粥样斑块性质结果,164例急性脑梗死患者(观察组)中无粥样斑块者49例、稳定粥样斑块者58例、不稳定粥样斑块者57例,以47例健康体检者为对照,比较2组的同型半胱氨酸(Hcy)、sdLDL-C、Lp-PLA2表达水平。统计患者入院时的美国国立卫生院卒中量表(NIHSS)得分,随访患者发病30 d的预后情况,并分析影响ACI预后的相关因素。结果 脑梗死患者的空腹血糖、甘油三酯、sdLDL-C/LDL-C、sdLDL-C/TC、Lp-PLA2水平均高于对照组,HDL-C水平低于对照组;有粥样斑块者的Hcy、sdLDL-C水平高于无粥样斑块者及对照组;不稳定粥样斑块者的TC、LDL-C水平高于无粥样斑块者及对照组,差异均有统计学意义(P<0.05)。预后不良组的不稳定粥样斑块发现率(45.78%)高于预后良好组(23.46%),入院时NIHSS评分及血糖、sdLDL-C、sdLDL-C/LDL-C、sdLDL-C/TC、Lp-PLA2水平均高于预后良好组,差异均有统计学意义(P<0.05)。结论 sdLDL-C、Lp-PLA2水平与急性脑梗死患者颈动脉粥样斑块的稳定性密切相关,对预后判断有积极意义。Objective To investigate the levels of small and dense low-density lipoprotein cholesterol(sdLDL-C)and lipoprotein-associated phospholipase A2(Lp-PLA2)in patients with acute cerebral infarction and their relationship with carotid atherosclerotic plaque stability.The study aims to provide ideas for early identification and improvement of patients'prognosis.Methods The study analysed the results of cervical vascular ultrasound examination of plaque characteristics in 164 patients with ACI(observation group).Of these,49 had no plaque,58 had stable plaque,and 57 had unstable plaque.The control group consisted of 47 healthy individuals undergoing physical examinations.The study compared the levels of homocysteine(Hcy),sdLDL-C,and Lp-PLA2 expression between the two groups.The study recorded the National Institutes of Health Stroke Scale(NIHSS)scores for the patients and evaluated their prognosis during the 30-day follow-up period.Additionally,the factors that affect the prognosis of acute cerebral infarction(ACI)were analyzed.Results In patients with acute coronary ischemia(ACI),fasting blood glucose(PBG),triglycerides(TG),sdLDL-C/LDL-C,sdLDL-C/TC,and Lp-PLA2 levels were higher than those in the control group.Additionally,HDL-C levels were lower in the patient group.Among patients with plaque,Hcy and sdLDL-C levels were higher than those without plaque and the control group.Patients with unstable plaque had higher levels of TC and LDL-C than those without plaque and the control group,with significant differences(P<0.05).The rate of unstable plaques detected in the poor prognosis group(45.78%)is higher than that in the good prognosis group(23.46%).The admission NIHSS score,blood glucose,sdLDL-C,sdLDL-C/LDL-C,sdLDL-C/TC,and Lp-PLA2 levels were all significantly higher in the poor prognosis group than in the good prognosis group(P<0.05).Conclusions The levels of sdLDL-C and Lp-PLA2 are closely related to the stability of carotid artery plaques in patients with ACI.They also have positive implications for prognosis assessm

关 键 词：小而密低密度脂蛋白胆固醇 脂蛋白相关磷脂酶A2 急性脑梗死 颈动脉粥样斑块 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]