Lp-PLA2 LP(a)ApoB/ApoA-1水平与急性脑梗死严重程度及预后的相关性分析  

Analysis of the Correlation between Levels of Lp-PLA2 LP(a) ApoB/ApoA-1 and the Severity and Prognosis of Acute Cerebral Infarction

作　　者：薛涵[1] 高静 王冬静[1] 赵雪 张艳利[1] 刘莉 王利民[1] 刘有为[1] XUE Han;GAO Jing;WANG Dongjing(Chengde Central Hospital,Hebei Chengde 067000,China)

机构地区：[1]河北省承德市中心医院,河北承德067000

出　　处：《河北医学》2024年第5期857-863,共7页Hebei Medicine

基　　金：2023年承德市科学技术局基础研究项目,(编号:202301A116)。

摘　　要：目的:探究脂蛋白相关磷脂酶A2(Lp-PLA2)、脂蛋白a[LP(a)]、载脂蛋白B(ApoB/)/载脂蛋白A-1(ApoA-1)的表达水平与急性脑梗死(ACI)的严重程度和预后的相关性。方法:选择我院2022年1月至2023年1月收治的ACI患者122例作为病例组,根据疾病严重程度分为轻度组(54例)、中度组(49例)、重度组(19例),另选择同期体检健康者作为对照组(97例)。根据预后效果分为预后良好组(88例)和预后不良组(34例)。比较病例组和对照组患者的基本资料和生化指标的差异性,分析Lp-PLA2、LP(a)、ApoB/ApoA-1的表达水平对患者病情严重程度和预后效果影响。结果:病例组患者年龄、吸烟史、高血压例数、收缩压、LDL-C、LP(a)、Lp-PLA2指标高于对照组(P<0.05),HDL-C指标低于对照组(P<0.05),多因素Logistic回归分析结果,年龄、吸烟史、高血压、收缩压、HDLC、LDLC、LPa、LpPLA2、ApoB/ApoA-1是影响ACI发生的独立危险因素(P<0.05)。重度组患者Lp-PLA2、LP(a)、ApoB/ApoA-1指标显著高于轻度组和中度组(P<0.05),中度组Lp-PLA2、LP(a)、ApoB/ApoA-1指标显著高于轻度组(P<0.05),Spearman相关性比较,Lp-PLA2、LP(a)、ApoB/ApoA-1指标与患者病情严重程度呈正相关(r=0.796、0.718、0.451,P<0.05)。预后良好组患者Lp-PLA2、LP(a)、ApoB/ApoA-1指标显著高于预后不良组(P<0.05),ROC曲线分析结果显示,联合预测AUC为0.987。结论:高龄、血压血脂异常、生活习惯较差者更易患ACI,而Lp-PLA2、ApoB/ApoA-1水平与ACI的严重程度和预后效果呈明显的相关性,通过检测可有效评估患者病情发展,具有较高临床价值。Objective:To explore the correlation between the expression levels of lipoprotein-associated phospholipase A2(Lp-PLA2),lipoprotein a[LP(a)],apolipoprotein B(ApoB)/apolipoprotein A-1(ApoA-1)and the severity and prognosis of acute cerebral infarction(ACI).Methods:A total of 122 ACI patients admitted to our hospital from January 2022 to January 2023 were selected as the case group.According to the severity of the disease,they were divided into mild(54 cases),moderate(49 cases),and severe(19 cases)groups.Another 97 healthy individuals who underwent physical examinations during the same period were selected as the control group.According to the prognosis,the patients were divided into a good prognosis group(88 cases)and a poor prognosis group(34 cases).Differences in basic information and biochemical indicators between the case group and control group were compared,and the impact of the expression levels of Lp-PLA2,LP(a),and ApoB/ApoA-1 on the severity of the disease and prognosis was analyzed.Results:The age,smoking history,number of hypertension cases,systolic blood pressure,LDL-C,LP(a),and Lp-PLA2 levels in the case group were higher than those in the control group(P<0.05),while the HDL-C level was lower in the case group than in the control group(P<0.05).Multivariate logistic regression analysis indicated that age,smoking history,hypertension,systolic blood pressure,HDL-C,LDL-C,LP(a),Lp-PLA2,and ApoB/ApoA-1 were independent risk factors for ACI(P<0.05).The levels of Lp-PLA2,LP(a),and ApoB/ApoA-1 in the severe group were significantly higher than those in the mild and moderate groups(P<0.05),and the levels in the moderate group were significantly higher than those in the mild group(P<0.05).Spearman correlation analysis showed that the levels of Lp-PLA2,LP(a),and ApoB/ApoA-1 were positively correlated with the severity of the disease(r=0.796,0.718,0.451;P<0.05).The levels of Lp-PLA2,LP(a),and ApoB/ApoA-1 in the good prognosis group were significantly higher than those in the poor prognosis group(P<0.05).ROC curve an

关 键 词：急性脑梗死 脂蛋白相关磷脂酶 脂蛋白A 载脂蛋白B/载脂蛋白A-1 

分 类 号：R743.33[医药卫生—神经病学与精神病学]