脂蛋白相关磷脂酶A2水平与急性缺血性脑卒中的相关性研究

摘要

Objective To investigate the variation and influence factors of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in the patients with acute ischemic cerebral stroke. Methods 192 cases with acute ischemic cerebral stroke as ischemic group ,according to National Institutes of Health Stroke Scale ,patients were divided into mild group (n=16), moderate group (n=163),and severe group (n=13) . 79 cases of healthy donors were selected at the same time as control. Enzyme-linked immunosorbent assay (ELISA) was performed to detect plasma Lp-PLA2 , besides we detact the white blood cells (WBC), neutrophil (NE) and blood Biochemical analysis. Results (1) Plasma level of Lp-PLA2 of stroke group were significantly higher than the control group , and severe group were higher than the moderate group which were higher than the mild group, the dif erences were al statistical y significant ( <0.05);(2) Stroke group of white blood cells (WBC), neutrophil (NE), cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), lipoprotein Lp (a), glucose (Glu) levels were markedly higher than the control group, the dif erence was statistical y significant ( <0.05);High density lipoprotein(HDL)was lower than the control group, the dif erence was statistical y significant ( <0.05);(3)Multiple linear regression analysis showed that:Lp-PLA2 was positively cor elated with age, obesity, NIHSS, had no correlation with gender, smoking, diabetes, high blood pressure,blood lipids. Conclusion Lp-PLA2 were increased in acute ischemic stroke, detection Lp-PLA2 can provide some help for the clinic treatment and secondary prevention.%目的：研究急性缺血性脑卒中患者血脂蛋白相关磷脂酶A2(Lp-PLA2)水平的变化及影响因素。方法将192例符合筛选标准的急性缺血性脑卒中患者设为卒中组、79例健康体检者设为对照组，前者又根据美国国立卫生院卒中量表(NIHSS)评价神经功能缺损程度，分为轻度(<4分)、中度(4~15分)、重度(>15分)3个组；采血检测血浆Lp-PLA2浓度、血常规和血生化。结果①脑卒中组患者Lp-PLA2浓度显著高于对照组，而且重度组高于中度组、中度组高于轻度组，差异均有统计学意义(P<0.05)；②脑卒中组血白细胞(WBC)、中性粒细胞(NE)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、脂蛋白Lp(a)、葡萄糖(Glu)水平明显高于对照组；高密度脂蛋白(HDL)低于对照组，差异均有统计学意义(P<0.05)；③多重线性回归分析显示院Lp-PLA2与年龄、肥胖、NIHSS评分呈正相关。结论在急性缺血性卒中中Lp-PLA2增高，检测Lp-PLA2可为临床的治疗和二级预防提供一定的帮助。