摘要
目的探讨急性脑梗死(ACI)患者血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血清脂蛋白相关磷脂酶A2(Lp-PLA2)、小而密低密度脂蛋白胆固醇(sdLDL-C)水平与神经功能缺损的关系。方法选取2016年1月—2020年1月南通市第二人民医院收治的118例ACI患者,另选取同期来院体检的106例健康者。比较ACI患者和健康者血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平,根据ACI患者神经功能缺损程度将其分为轻度组(n=31例),中度组(n=48)和重度组(n=39),比较3组患者血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平,比较重度组与轻中度组患者临床特征,采用Logistic回归分析影响ACI患者重度神经功能缺损的危险因素,采用受试者工作曲线(ROC)分析血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平评估ACI重度神经功能缺损的价值。结果ACI患者血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平均高于健康者(P<0.05);重度组患者NIHSS评分、脑梗死体积、白细胞计数、同型半胱氨酸、hs-CRP、IL-6、Lp-PLA2、sdLDL-C均高于轻中度组患者(P<0.05);Logistic多因素回归分析,结果显示NIHSS评分、脑梗死体积、hs-CRP、IL-6、Lp-PLA2、sdLDL-C均是影响ACI重度神经功能缺损的独立危险因素(P<0.05);ROC分析显示,血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平评估ACI患者重度神经功能缺损的最佳截断点分别为14.50 mg/L、50.58 pg/mL、210.72 ng/mL、1.34 mmol/L,曲线下面积(AUC)分别为0.765、0.749、0.792、0.803,四者联合的特异度和AUC分别为94.25%和0.900。结论ACI患者血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平均异常升高,临床检测血清hs-CRP、IL-6、Lp-PLA2、sdLDL-C水平可作为评估ACI患者神经功能缺损的敏感指标。
Objective To explore the correlation of high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),serum lipoprotein-related phospholipase A2(Lp-PLA2),small and dense low-density lipoprotein cholesterol(sdLDLC)level with neurological deficit in patients with acute cerebral infarction(ACI).Methods 118 patients with ACI were hospitalized and divided into 3 groups according to the degree of neurological deficit:mild group(n=31),moderate group(n=48)and severe group(n=39),106 healthy persons who came to the hospital for physical examination during the same period were selected as controls.Peripheral fasting venous blood samples were collected to test the serum hs-CRP,IL-6,Lp-PLA2,and sdLDL-C levels.Logistic regression was used to analyze the risk factors of severe neurological deficit in the patients with ACI,and receiver operating curve(ROC)was used to analyze the values of serum hs-CRP,IL-6,Lp-PLA2,and sdLDL-C levels in assessing the severeity of neurological deficit in the ACI patients.Results The levels of serum hs-CRP,IL-6,Lp-PLA2,and sdLDL-C of the ACI patients were all significantly higher than those of the healthy persons(all P<0.05).The NIHSS score,cerebral infarction volume,white blood cell count,homocysteine,hs-CRP,IL-6,Lp-PLA2,sdLDL-C of the severe group were all significantly higher than those of the mild to moderate group(all P<0.05).Logistic multivariate regression analysis showed that NIHSS score,cerebral infarction volume,hs-CRP,IL-6,Lp-PLA2,and sdLDL-C are all independent risk factors affecting severe neurological deficit in patients with ACI(P<0.05).ROC analysis showed that the best cut-off points for serum hs-CRP,IL-6,Lp-PLA2,and sdLDL-C levels to assess severe neurological deficits in patients with ACI were 14.50 mg/L,50.58 ng/L,210.72 ng/mL,1.34 mmol/L,the area under the curve(AUC)were 0.765,0.749,0.792,0.803,and the specificity and AUC of the combination of the four were 94.25%and 0.900,respectively.Conclusion Serum hs-CRP,IL-6,Lp-PLA2,and sdLDL-C levels in patients with ACI are abnormally
作者
刘香
顾玲莉
江齐群
胡越
LIU Xiang;GU Lingli;JIANG Qiqun;HU Yue(Clinical Laboratory,Second Nantong People's Hospital,Nantong Jiangsu 226002,China)
出处
《中国急救复苏与灾害医学杂志》
2022年第11期1439-1442,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省青年医学重点人才培养项目(编号:GNRC2016764)。
关键词
ACI
超敏C反应蛋白
白细胞介素-6
血清脂蛋白相关磷脂酶A2
小而密低密度脂蛋白胆固醇
神经功能缺损
Acute cerebral infarction
High-sensitivity C-reactive protein
Interleukin-6
Serum lipoprotein-related phospholipase A2
Small and dense low-density lipoprotein cholesterol
Neurological deficit
