脂蛋白相关性磷脂酶和神经元特异性烯醇化酶在急性脑梗死患者中的动态变化及意义

摘要

Objective To study the change of serum lipoprotein-associated phosphorlipase A2 (Lp-PLA2) and neuron specific enolase (NSE) and its clinical significance in patients with acute cerebral infarction (ACI).Methods Fifty-two ACI patients served as ACI group and 45 subjects undergoing physical examination served as control group.The patients in ACI group were further divided into mild ACI group (n =10),moderate ACI group (n =26) and severe ACI group (n =16) according to their NIHSS score.Relationship of serum Lp-PLA2 and NSE levels with NIHSS score in ACI patients was analyzed.Results The serum Lp-PLA2 and NSE levels were significantly higher in ACI group than in control group (289.3±19.4 μg/L vs 123.4±28.4 μg/L,22.1±2.8 μg/L vs 7.2±1.9 tμg/L,P＜0.05),and in moderate and severe ACI group than in mild ACI group (P＜0.05).The serum Lp-PLA2 and NSE levels and NIHSS score were significantly higher on days 2-7 than on day 1 after treatment (P＜0.05) and significantly lower on days 6 and 7 than on day 5 after treatment (P＜0.05).Pearson correlation analysis showed that serum Lp-PLA2 and NSE level were positively related with NIHSS score in ACI group (r =0.788,P =0.035;r=0.950,P=0.001).Conclusion Lp-PLA2 and NSE play an important role in the occurrence and progression of ACI,and are closely related with the severity and outcome of ACI,which can thus provide reference for the treatment,outcome and assessment of ACI.%目的 探讨血清脂蛋白相关性磷脂酶A2 (Lp-PLA2)和神经元特异性烯醇化酶(NSE)水平变化在急性脑梗死(ACI)患者中的临床意义.方法 采用回顾性病例对照分析.选取ACI患者52例(ACI组),分别依据美国国立卫生研究院卒中量表(NIHSS)评分将其分为轻度ACI组10例(1～4分)、中度ACI组26例(5～15分)和重度ACI组16例(＞15分).另选取健康体检者45例为对照组.分析血清Lp PLA2、NSE水平与NIHSS评分的关系.结果 ACI组血清Lp-PLA2、NSE水平均显著高于对照组[(289.3±19.4)μg/L vs (123.4±28.4)μg/L、(22.1±2.8)μg/L vs (7.2±1.9)μg/L,P＜0.05)].中度ACI组和重度ACI组患者血清Lp-PLA2、NSE水平显著高于轻度ACI组(P＜0.05).与治疗后第1天比较,ACI组患者第2～7天血清Lp-PLA2、NSE水平和NIHSS评分显著增加(P＜0.05),与治疗后第5天比较,第6～7天血清Lp-PLA2、NSE水平和NIHSS评分显著降低,差异有统计学意义(P＜0.05).Pearson相关性分析显示,ACI组患者血清Lp-PLA2、NSE表达水平与NIHSS评分呈正相关(r=0.788,P=0.035;r=0.950,P=0.001).结论 Lp-PLA2和NSE在ACI的发生发展中发挥着重要的作用,与患者病情及预后密切相关,为ACI患者的治疗、预后和评估提供参考依据.