摘要
目的探讨血清脂蛋白相关磷脂酶A2（Lp-PLA2）与急性缺血性脑卒中患者早期神经功能恶化（END）的相关性。方法连续性入组自2011年1月至2015年7月在盐城市第三人民医院神经内科住院的经影像学确诊的急性缺血性脑卒中患者255例，测定患者血清Lp-PLA2、超敏C反应蛋白（hs-CRP）水平。依据＂患者入院后72 h内复评美国国立卫生研究院卒中量表（NIHSS）评分较入院时增加2分或2分以上＂标准定义END，并将患者分为END患者组和非END患者组，通过2组临床资料比较及建立Logistic回归模型分析血清Lp-PLA2水平与急性缺血性脑卒中患者END的相关性。结果纳入的255例急性缺血性脑卒中患者中有72例（28.23%）发生了END。END患者组的女性比例（61.1% vs. 43.7%）、吸烟者比例（58.3% vs. 31.3%）、糖尿病比例（73.6% vs. 16.9%）、脑卒中史比例（44.4% vs. 25.1%）、NIHSS评分[8（3）分vs. 3（2）分]、血清Lp-PLA2水平[ （230.31±75.57） μg/L vs. （87.60±28.45） μg/L]和hs-CRP水平[（20.08±8.05） mg/L vs. （6.73±3.48） mg/L]均明显高于非END患者组，差异均有统计学意义（P〈0.05）。Logistic回归分析显示，矫正混杂因素后，糖尿病（OR=4.903 ，95%CI：1.363~17.695，P=0.015）、血清Lp-PLA2水平（OR=1.032, 95% CI：1.013~1.043 ，P=0.000）及hs-CRP水平（OR=1.229，95%CI： 1.087~1.391，P=0.001）是急性缺血性脑卒中患者发生END的独立危险因素。结论血清Lp-PLA2水平升高与急性缺血性脑卒中患者END的发生密切相关。
Objective To determine the association between serum lipoprotein-associated phospholipase A2 （Lp-PLA2） and early neurological deterioration （END） in patients with acute ischemic stroke （AIS）. Methods Two hundred and fifty-five AIS patients diagnosed by MR imaging were recruited between January 2011 and July 2015. The levels of serum Lp-PLA2 and high-sensitivity C-reactive protein （hs-CRP） were assessed right after hospitalization. END was defined as any increase in National Institutes of Health Stroke Scale （NIHSS） scores t〉2 in the first 72 h after stroke onset, and the patients were accordingly divided into END group and non-END group. Risk factors associated with END and their clinical data were analyzed by Logistic regression analysis. Results END was observed in 72 of the 255 patients （28.23%）. The percentage of femaIe （58.3% vs. 31.3%）, smoking ratio （58.3% vs. 31.3%）, diabetes meUitus ratio （73.6% vs. 16.9%）, prior stroke ratio （44.4% vs. 25.1%）, NHISS scores （8 [3] vs. 3 [2]）, serum Lp-PLA2 level （230.31 ±75.57 p,g/L vs. 87.60±28.45 p,g/L） and hs-CRP level （20.08±8.05 mg/L vs. 6.73±3.48 rag/L） in the END group were significantly higher than those in the non-END group （P〈0.05）. Multiple Logistic regression analyses indicated that END was positively associated with diabetes mellitus （OR=4.903, 95%CI： 1.363-17.695, P=0.015）, Lp-PLA2 level （OR=1.032, 95%CI： 1.013-1.043, P=-0.000） and hs-CRP level （OR=1.229, 95%CI： 1.087-1.391, P=- 0.001） in patients with acute ischemic stroke. Conclusion Serum Lp-PLA2 may predict END in Chinese patients with acute ischemic stroke.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2016年第8期825-829,共5页
Chinese Journal of Neuromedicine
