血清Lp-PLA2、S100β对急性脑梗死患者疾病转归的预测价值  

The predictive values of serum Lp-PLA 2 and S100βin the outcome of acute cerebral infarction

作　　者：韩雪 尚小洁 张利莎 HAN Xue;SHANG Xiao-jie;ZHANG Li-sha

机构地区：[1]安阳市第三人民医院神经内科,河南安阳455000

出　　处：《中国疗养医学》2025年第4期79-84,共6页Chinese Journal of Convalescent Medicine

摘　　要：目的 探讨急性脑梗死(ACI)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、S100钙结合蛋白β(S100β)水平变化,并分析其对疾病转归的预测价值。方法 选取2022年5月至2024年5月安阳市第三人民医院收治的120例ACI患者开展回顾性分析,均予以溶栓治疗,依据治疗后3个月疾病转归情况分为转归良好组68例、转归不良组52例,比较两组临床资料及治疗前、治疗后1个月血清Lp-PLA2、S100β水平。多因素Logistic回归分析疾病转归的影响因素。偏相关性分析血清Lp-PLA2、S100β水平与疾病转归的相关性。评价治疗后1个月血清Lp-PLA2、S100β水平对疾病转归的预测价值。分析Lp-PLA2、S100β对疾病转归的独立作用及交互作用。结果 转归不良组治疗后1个月血清Lp-PLA2、S100β水平高于转归良好组(P<0.05);高血压、房颤史、病情程度及血清高敏C反应蛋白(hs-CRP)、Lp-PLA2、S100β水平为疾病转归的独立危险因素(P<0.05);在剔除高血压、房颤史、病情程度、血清hs-CRP水平等其他混杂影响因素后,血清Lp-PLA2、S100β水平仍与疾病转归不良呈显著正相关(P<0.001);血清Lp-PLA2、S100β水平联合预测疾病转归的AUC值大于单项指标预测(P<0.05);建立模型1(调整混杂因素)、模型2(调整高血压、房颤史、病情程度)、模型3(调整高血压、房颤史、病情程度、血清hs-CRP水平),在模型1、模型2、模型3中,Lp-PLA2高表达者疾病转归不良风险分别是低表达者的2.305倍、2.597倍、2.944倍,S100β高表达者疾病转归不良风险分别是低表达者的2.195倍、2.522倍、2.747倍,且交互作用分析显示Lp-PLA2与S100β对疾病转归存在协同作用。结论 ACI转归不良者血清Lp-PLA2、S100β水平升高,且为疾病转归的独立危险因素,同时Lp-PLA2与S100β对疾病转归存在协同作用,联合检测其水平对疾病转归具有一定预测价值。Objective To investigate the changes in serum lipoprotein-associated phospholipase A2(Lp-PLA2)and S100 calcium-binding protein beta(S100β)levels in patients with acute cerebral infarction(ACI),and to analyze their predictive value in the outcome.Methods A total of 120 ACI patients admitted to the Third People's Hospital of Anyang City from May 2022 to May 2024 were retrospectively analyzed.All of them received thrombolytic therapy.Based on the disease outcomes at 3 months of treatment,68 patients were categorized into the good outcome group and 52 patients into the poor outcome group.The clinical data,and serum Lp-PLA2 and S100βlevels before and 1 month after treatment were compared.Multivariate logistic regression analysis was used to analyze the influencing factors for the outcome of ACI.The correlation of serum Lp-PLA2 and S100βlevels with the outcome of ACI was analyzed by partial correlation analysis.The predictive value of serum Lp-PLA2 and S100βin the 1-month outcome of ACI was evaluated.The independent and interactive effects of Lp-PLA2 and S100βon the outcome of ACI were analyzed.Results Serum Lp-PLA2 and S100βat 1 month of treatment in the poor outcome group were significantly higher than those of the good outcome group(P<0.05).Hypertension,atrial fibrillation history,disease severity,and serum levels of high-sensitivity C-reactive protein(hs-CRP),Lp-PLA2,and S100βwere independent risk factors for the outcome of ACI(P<0.05).After excluding other confounding factors like hypertension,atrial fibrillation history,disease severity,and serum hs-CRP levels,serum Lp-PLA2 and S100βlevels were still significantly positively correlated with the poor disease outcomes(P<0.001).The area under the curve(AUC)of the combined prediction of serum Lp-PLA2 and S100βlevels in the prognosis of ACI was significantly greater than that of a single indicator(P<0.05).Model 1(adjusting for confounding factors),model 2(adjusting for hypertension,atrial fibrillation history,and disease severity),and model 3(adjusting for hy

关 键 词：急性脑梗死 脂蛋白相关磷脂酶A2 S100钙结合蛋白β 疾病转归 预测 

分 类 号：R743.33[医药卫生—神经病学与精神病学]