摘要
目的 分析血清脂蛋白磷脂酶A2(L_(p)-PLA2)、淀粉样蛋白A(SAA)和血小板内皮细胞黏附分子-1(PECAM-1)水平与急性脑梗死(ACI)病情程度和疾病预后的相关性。方法 选择2021年7月—2022年6月海安市人民医院急诊科收治的高血压合并ACI患者180例,根据血清同型半胱氨酸(Hcy)水平分为观察组124例(H型高血压)和对照组56例(单纯高血压)。观察组再根据颈部超声检查结果分为非易损斑块亚组45例和易损斑块亚组79例,根据发病72 h内美国国立卫生院卒中量表(NIHSS)评分较入院时的变化值分为非早期神经功能恶化亚组(非END亚组)53例和END亚组71例,根据发病后90 d的改良Rankin量表(mRS)评分分成预后良好亚组89例和预后不良亚组35例。比较各组血清L_(p)-PLA2、SAA、PECAM-1水平。Pearson分析血清L_(p)-PLA2、SAA、PECAM-1水平与Hcy水平、Alberta卒中项目早期CT(ASPECTS)评分、急性生理与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的相关性;绘制受试者工作特征曲线(ROC)分析血清L_(p)-PLA2、SAA、PECAM-1评估H型高血压合并ACI的效能。结果 血清L_(p)-PLA2、SAA、PECAM-1水平比较,观察组高于对照组(t/P=6.481/0.005、8.154/<0.001、7.462/<0.001),易损斑块亚组高于非易损斑块亚组(t/P=7.628/<0.001、8.319/<0.001、8.615/<0.001),END亚组高于非END亚组(t/P=7.854/<0.001、8.627/<0.001、9.825/<0.001),预后不良亚组高于预后良好亚组(t/P=7.915/<0.001、8.968/<0.001、8.763/<0.001)。Pearson分析显示,血清L_(p)-PLA2、SAA、PECAM-1水平与Hcy、APACHEⅡ评分均呈正相关(Hcy:r/P=0.691/<0.001、0.725/<0.001、0.674/<0.001;APACHEⅡ评分:r/P=0.591/<0.001、0.640/<0.001、0.683/<0.001),与ASPECTS评分呈负相关(r/P=-0.598/<0.001、-0.703/<0.001、-0.629/<0.001)。血清L_(p)-PLA2、SAA、PECAM-1及三者联合检测评估H型高血压合并ACI的曲线下面积(AUC)分别为0.681、0.709、0.754、0.924,三者联合检测评估效能高于单项检测(Z=6.863、7.418、7.905,P�
Objective To analyze the correlation between the levels of serum lipoprotein phospholipase A2(L_(p)-PLA2), amyloid A(SAA) and platelet endothelial cell adhesion molecule-1(PECAM-1) and the severity and prognosis of acute cerebral infarction(ACI). Methods One hundred and eighty patients with hypertension complicated with ACI admitted to the Emergency Department of Hai’an People’s Hospital from July 2021 to June 2022 were selected. According to the level of serum homocysteine(Hcy), they were divided into the observation group(124 patients with type H hypertension) and the control group(56 patients with simple hypertension). The observation group was further divided into non-vulnerable plaque subgroup(45 cases) and vulnerable plaque subgroup(79 cases) according to the results of neck ultrasound examination. According to the changes in the score of the National Institutes of Health Stroke Scale(NIHSS) within 72 hours after the onset of the disease, the observation group was divided into non-early neurological deterioration subgroup(non-END subgroup)(53 cases) and END subgroup(71 cases). According to the score of the modified Rankin Scale(mRS) 90 days after the onset of the disease, the observation group was divided into a subgroup with good prognosis(89 cases) and a subgroup with poor prognosis(35 cases). The levels of serum L_(p)-PLA2, SAA and PECAM-1 in each group were compared. Pearson analyzed the correlation between the levels of serum L_(p)-PLA2, SAA, PECAM-1 and the level of Hcy, the early CT score of Alberta Stroke Project(ASPECTS), and the score of acute physiology and chronic health status scoring system II(APACHE II);The efficacy of serum L_(p)-PLA2, SAA and PECAM-1 in evaluating type H hypertension complicated with ACI was analyzed by drawing the working characteristic curve(ROC) of subjects. Results Compared with the levels of serum L_(p)-PLA2, SAA and PECAM-1, the observation group was higher than the control group(t/P=6.481/0.005, 8.154/<0.001, 7.462/<0.001), the vulnerable plaque subgroup was high
作者
张蔓青
刘君利
许小伟
崔杨慧
Zhang Manqing;Liu Junli;Xu Xiaowei;Cui Yanghu(Department of Emergency,Haian City People's Hospital,Jiangsu Province,Haian 226600,China)
出处
《疑难病杂志》
CAS
2023年第3期272-277,283,共7页
Chinese Journal of Difficult and Complicated Cases
基金
南通市2018年度市级科技计划项目(MSZ18233)。
