摘要
目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、血管紧张素1-7(Ang1-7)水平与老年急性脑梗死(ACI)患者并发血管性痴呆(VaD)的关系。方法选取2018年5月—2020年5月重庆大学附属中心医院收治的122例老年ACI患者为研究对象,根据是否合并VaD分为ACI-VaD组(54例)和ACI-NVaD组(68例);根据临床痴呆评定量表将ACI-VaD组分为轻度痴呆组(13例)、中度痴呆组(16例)、重度痴呆组(25例)。比较各组血清Lp-PLA2、Ang1-7水平,多因素logistic回归分析老年ACI患者并发VaD的影响因素,ROC曲线分析血清Lp-PLA2、Ang1-7水平对ACI并发VaD的预测价值。结果两组血清总胆固醇、高密度脂蛋白胆固醇、超敏C反应蛋白(hs-CRP)、Lp-PLA2、Ang1-7比较,差异有统计学意义(P<0.05)。重度痴呆组血清Lp-PLA2水平高于中度痴呆组、轻度痴呆组,Ang1-7水平低于中度痴呆组、轻度痴呆组;中度痴呆组血清Lp-PLA2水平高于轻度痴呆组,Ang1-7水平低于轻度痴呆组,差异均有统计学意义(均P<0.05)。hs-CRP、Lp-PLA2为老年ACI患者并发VaD的独立危险因素(OR>1,P<0.05),Ang1-7为独立保护因素(OR<1,P<0.05)。Lp-PLA2+Ang1-7预测老年ACI患者并发VaD的曲线下面积、敏感度、特异性、准确度大于Lp-PLA2、Ang1-7单独预测。结论老年ACI患者并发VaD后血清Lp-PLA2水平明显升高,Ang1-7水平明显降低,为并发VaD的独立影响因素,联合检测能提升VaD预测价值。
Objective To investigate the relationship between serum lipoprotein-related phospholipase A2(Lp-PLA2)and angiotensin 1-7(Ang1-7)levels and vascular dementia(VaD)in elderly patients with acute cerebral infarction(ACI).Methods A total of 122 ACI patients admitted to Chongqing University Central Hospital from May 2018 to May 2020 were selected as study objects.They were divided into ACI-VaD group(54 cases)and ACI-NVaD group(68 cases)according to whether VaD was combined;according to clinical dementia rating scale,ACI-VaD group was divided into mild dementia group(13 cases),moderate dementia group(16 cases),and severe dementia group(25 cases).The serum Lp-PLA2 and Ang1-7 levels in each group were compared,the multivariate logistic regression analysis was used to analyze the influencing factors of VaD in elderly patients with ACI,and the ROC curve was used to analyze the predictive value of serum Lp-PLA2 and Ang1-7 levels in ACI complicated with VaD.Results There were statistically significant differences in serum total cholesterol,high density lipoprotein cholesterol,high-sensitivity C-reactive protein(hs-CRP),Lp-PLA2 and Ang1-7 between two groups(P<0.05).The level of serum Lp-PLA2 in severe dementia group was higher than that in moderate dementia group and mild dementia group,and the level of serum Ang1-7 was lower than that in moderate dementia group and mild dementia group;the level of serum Lp-PLA2 in moderate dementia group was higher than that in mild dementia group,and the level of serum Ang1-7 in moderate dementia group was lower than that in mild dementia group,with statistical significance(all P<0.05).Hs-CRP and Lp-PLA2 were independent risk factors for VaD in elderly patients with ACI(OR>1,P<0.05),Ang1-7 was an independent protective factor(OR<1,P<0.05).The area under the curve,sensitivity,specificity and accuracy of Lp-PLA2+Ang1-7 predicting elderly patients with ACI complicated with VaD were greater than those of Lp-PLA2 and Ang1-7 alone.Conclusion Serum Lp-PLA2 level is significantly increased and Ang1-
作者
褚静鑫
王玉
李宝善
蒋宜
林秋梅
CHU Jingxin;WANG Yu;LI Baoshan;JIANG Yi;LIN Qiumei(Department of General Practice,Chongqing University Central HospitalChongqing Emergency Medical Center,Chongqing400014,China;Clinical Skills Training Center,Chongqing University Central HospitalChongqing Emergency Medical Center,Chongqing400014,China)
出处
《中国医药导报》
CAS
2021年第11期86-90,共5页
China Medical Herald
基金
重庆市卫生计生委医学科研项目(2016MSXM80)。
