血清脂蛋白相关磷脂酶A2与青年缺血性脑卒中患者颅内动脉狭窄的相关性  

Correlation between serum lipoprotein-associated phospholipase A2 and intracranial artery stenosis in young patients with ischemic stroke

作　　者：周志奎 范白云 陈强[1] 柯先金[2] ZHOU Zhikui;FAN Baiyun;CHEN Qiang;KE Xianjin(People’s Hospital Affiliated to Jiangsu University,Zhenjiang 212000,China;Affiliated Hospital of Jiangsu University,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属人民医院,江苏镇江212000 [2]江苏大学附属医院,江苏镇江212001

出　　处：《中国实用神经疾病杂志》2025年第2期213-217,共5页Chinese Journal of Practical Nervous Diseases

基　　金：镇江市社会发展计划项目(编号:SH2021074);江苏大学附属医院引进人才启动基金项目(编号:jdfyRC2019007)。

摘　　要：目的研究血清脂蛋白相关磷脂酶A2(Lp-PLA2)与青年缺血性脑卒中患者颅内动脉狭窄的相关性。方法选取110例青年缺血性脑卒中患者为观察组,同期住院的100例青年非急性脑卒中患者为对照组,将观察组分为颅内动脉狭窄≥50%的狭窄组、<50%的动脉粥样硬化组和无颅内动脉狭窄的无狭窄组。比较观察组及对照组患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、空腹血糖(Glu)、血清尿酸(UA)、甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及血浆D-二聚体(D-D)水平变化,并进行相关性分析。结果观察组、对照组血清Lp-PLA2水平分别为[300.10(223.60,313.44)μg/L]、[52.68(24.45,72.00)μg/L],组间比较差异有统计学意义(P<0.05)。观察组中狭窄组、动脉粥样硬化组、无狭窄组Lp-PLA2水平分别为324.18(313.50,334.24)μg/L、300.17(297.60,304.24)μg/L、218.15(211.00,230.08)μg/L,3组呈下降趋势,组间比较差异有统计学意义(P<0.05)。Spearman相关分析显示血清Lp-PLA2与急性青年缺血性脑卒中患者颅内动脉狭窄呈正相关(r=0.653,P<0.001)。有序多分类Logistic回归分析提示UA水平(OR=1.006,95%CI:1.002~1.011,P=0.005)、Lp-PLA2水平(OR=1.016,95%CI:1.011~1.020,P<0.001)、LDL-C水平(OR=2.159,95%CI:1.237~3.769,P=0.007)为动脉粥样硬化的危险因素。结论血清脂蛋白相关磷脂酶A2(Lp-PLA2)与青年缺血性脑卒中患者颅内动脉粥样硬化性狭窄密切相关,可能为其危险因素。Objective To study the correlation between serum lipoprotein-associated phospholipase A2(Lp-PLA2)and intracranial artery stenosis in young adult patients with ischemic stroke.Methods Totally 110 young adult patients with ischemic stroke were selected as the observation group and 100 young non-acute stroke patients hospitalized during the same period were selected as the control group.The observation group was divided into the stenosis group with greater than or equal to 50%intracranial artery stenosis,the atherosclerosis group with less than 50%intracranial artery stenosis,and the non-stenosis group without intracranial artery stenosis.The changes in serum Lp-PLA2,fasting blood sugar,serum UA,TG,serum TC,LDL-C,HDL-C and plasma D-D levels of patients in the observation group and the control group were compared,and their correlations with intracranial atherosclerotic aortic stenosis were analyzed.Results The serum Lp-PLA2 levels of the observation group and the control group were 300.10(223.60,313.44)μg/L and 52.68(24.45,72.00)μg/L,respectively.The comparative differences between the groups were statistically significant(P<0.05).In the observation group,the levels of Lp-PLA2 in the stenosis group,the atherosclerosis group,and the non-stenosis group were 324.18(313.50,334.24)μg/L,300.17(297.60,304.24)μg/L,and 218.15(211.00,230.08)μg/L,respectively.The three groups showed a downward trend,and the comparative differences between the groups were statistically significant(P<0.05).Spearman correlation analysis showed that serum Lp-PLA2 was positively correlated with intracranial artery stenosis in patients with acute young adult ischemic stroke(r=0.653,P<0.001).Ordered multi-classification Logical regression analysis suggested serum UA levels(OR=1.006,95%CI:1.002-1.011,P=0.005),Lp-PLA2 levels(OR=1.016,95%CI:1.011-1.020,P<0.001),LDL-C levels(OR=2.159,95%CI:1.237-3.769,P=0.007)were risk factors for atherosclerosis.Conclusion Lp-PLA2 is closely related to intracranial atherosclerotic stenosis in young adult ischemic st

关 键 词：缺血性脑卒中 脂蛋白相关磷脂酶A2 动脉粥样硬化 颅内动脉狭窄 青年 

分 类 号：R743.33[医药卫生—神经病学与精神病学]