摘要
目的 研究急性缺血性脑卒中患者脂蛋白相关磷脂酶A2(Lp-PLA2)、氧化低密度脂蛋白(oxLDL)及系统免疫炎症指数(SII)在临床预后的评估中的应用.方法 回顾性选取2022年1月至2024年1月在榆林市第一医院就诊的急性缺血性脑卒中患者104例作为研究对象.采用改良Rankin量表评分判定患者3个月后的预后情况,将患者分为预后良好组36例(分数＜2分)及预后不良组68例(分数≥2分).收集患者基线资料,包括性别、年龄、体重指数、吸烟史、高血压史、饮酒史、冠心病史、高血脂史、收缩压、舒张压情况.检测并比较两组Lp-PLA2、ox-LDL及SII水平.采用多因素Logistic回归分析法分析影响急性缺血性脑卒中患者临床预后的因素;采用受试者操作特征(ROC)曲线分析Lp-PLA2、ox-LDL及SII预测患者预后的效能.结果 两组基本资料比较,差异均无统计学意义(P＞0.05);预后良好组 Lp-PLA2、ox-LDL、SII 水平分别为(106.45±6.58)mg/L、(3 502.52±85.65)μg/dL、610.54±150.23,均低于预后不良组[(116.84±6.89)mg/L、(3 658.45±95.68)pg/dL、925.46±180.25],差异均有统计学意义(P＜0.05).经多因素Logistic回归分析证实,Lp-PLA2、ox-LDL及SII均是影响急性缺血性脑卒中患者预后的危险因素(P＜0.05).经ROC曲线分析证实,Lp-PLA2、ox-LDL及SII均可用于急性缺血性脑卒中患者临床预后的预测,曲线下面积分别为0.871、0.908、0.955(P＜0.05).结论 在急性缺血性脑卒中患者体内,Lp-PLA2、ox-LDL及SII均呈现出明显的升高趋势,可为临床检测急性缺血性脑卒中患者预后情况提供可靠参考依据.
Abstract
Objective To study the application of lipoprotein-associated phospholipase A2(Lp-PLA2),oxidized low density lipopro-tein(oxLDL)and systemic immune inflammatory index(SII)in the evaluation of clinical prognosis in patients with acute ischemic stroke.Meth-ods A total of 104 patients with ischemic stroke admitted to Yulin First Hospital from January 2022 to January 2024 were tested.The prognosis of patients after 3 months was judged by modified Rankin scale,and the patients were divided into good prognosis group with 36 patients(score＜2 points)and poor prognosis group with 68 patients(score≥2 points).Baseline data of patients were collected,including gender,age,body mass index,smoking history,hypertension history,drinking history,coronary heart disease history,hyperlipidemia history,systolic blood pressure and diastolic blood pressure.The levels of Lp-PLA2,ox-LDL and SII were detected and compared between the two groups.The factors affecting the clinical prognosis of patients with acute ischemic stroke was analyzed using multivariate Logistic regression analysis.The efficacy of Lp-PLA2,ox-LDL and SII in predicting the prognosis of patients was analyzed using the receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in the basic data between the two groups(P＞0.05);the levels of Lp-PLA2,ox-LDL and SII in the good prognosis group were(106.45±6.58)mg/L,(3 502.52±85.65)μg/dL,610.54±150.23,respectively,which were lower than those in the poor prognosis group[(116.84±6.89)mg/L,(3 658.45±95.68)μg/dL,925.46±180.25],the differences were statistically significant(P＜0.05).Multivariate Logistic regression analysis showed that LP-PLA2,OX-LDL and SIIwere risk factors for the prognosis of patients with acute ischemic stroke(P＜0.05).ROC curve analysis confirmed that Lp-PLA2,ox-LDL and SII could be used to predict the clinical prognosis of patients with acute ischemic stroke,and the areas under the curve were 0.871,0.908 and 0.955,respectively(P＜0.05).Conclusion In patients with acute ischemic stroke,Lp-PLA2,ox-LDL and SII all showed an obvious upward trend,which can provide relia-ble reference for clinical detection of the prognosis of patients with acute ischemic stroke.
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