本文選題：急性腦梗死　切入點(diǎn)：脂蛋白相關(guān)磷脂酶A　出處：《中風(fēng)與神經(jīng)疾病雜志》2017年12期 　論文類型：期刊論文

【摘要】：目的研究大動(dòng)脈粥樣硬化型急性腦梗死患者住院時(shí)的脂蛋白相關(guān)磷脂酶A2水平、微栓子信號(hào)對(duì)其短期預(yù)后的影響。方法募集起病72 h內(nèi)的大動(dòng)脈粥樣硬化型急性腦梗死患者238例,收集其入院時(shí)的臨床資料及實(shí)驗(yàn)室資料等。根據(jù)改良Rankin量表評(píng)分將患者分為預(yù)后良好組(0~2分)和預(yù)后不良組(2分)。將研究對(duì)象分為4組:脂蛋白相關(guān)磷脂酶A2正常、微栓子信號(hào)陰性組(NL/NM);脂蛋白相關(guān)磷脂酶A2正常、微栓子信號(hào)陽(yáng)性組(NL/IM);脂蛋白相關(guān)磷脂酶A2升高、微栓子信號(hào)陰性組(IL/NM);脂蛋白相關(guān)磷脂酶A2升高、微栓子信號(hào)陽(yáng)性組(IL/IM)。采用非條件Logistic回歸分析脂蛋白相關(guān)磷脂酶A2水平、微栓子信號(hào)與急性腦梗死短期預(yù)后的關(guān)系。結(jié)果急性腦梗死患者預(yù)后不良組入院時(shí)的脂蛋白相關(guān)磷脂酶A2水平、微栓子信號(hào)陽(yáng)性率均高于預(yù)后良好組(均P0.05)。經(jīng)多因素調(diào)整后,與NL/NM相比,NL/IM、IL/NM和IL/IM組發(fā)生預(yù)后不良的OR值(95%CI)分別為0.719(0.112~4.627)、4.687(1.506~14.588)和14.868(3.373~65.538)。結(jié)論急性腦梗死患者入院時(shí)脂蛋白相關(guān)磷脂酶A2水平是其短期預(yù)后不良的獨(dú)立危險(xiǎn)因素,微栓子信號(hào)陽(yáng)性顯著放大了高水平脂蛋白相關(guān)磷脂酶A2對(duì)發(fā)生短期預(yù)后不良的作用,脂蛋白相關(guān)磷脂酶A2/微栓子信號(hào)是大動(dòng)脈粥樣硬化型急性腦梗死短期預(yù)后不良的預(yù)測(cè)指標(biāo)。
[Abstract]:Objective to study the level of lipoprotein associated phospholipase A 2 in patients with atherosclerotic acute cerebral infarction (ACI). Methods 238 patients with atherosclerotic acute cerebral infarction within 72 hours were recruited. According to the modified Rankin scale, the patients were divided into good prognosis group (0 ~ 2 points) and poor prognosis group (2 points). The subjects were divided into 4 groups: lipoprotein associated phospholipase A2 was normal. Negative microemboli signal group (NL / NMN); normal lipoprotein associated phospholipase A 2 (LPA2), positive microembolus signal positive group (NL / IMA); lipoprotein associated phospholipase A 2 (Lipoprotein associated phospholipase A 2) increased, and microemboli signal negative group (P < 0 05); lipoprotein associated phospholipase A 2 (PLA2) increased. The level of lipoprotein associated phospholipase A 2 was analyzed by non conditional Logistic regression analysis. Results the level of lipoprotein associated phospholipase A 2 and the positive rate of microemboli signal in patients with acute cerebral infarction were higher than those in patients with good prognosis (P 0.05). Compared with NL/NM, the OR value of poor prognosis in NL / IMR / NM and IL/IM groups were 0.719 鹵0.1124.627 and 14.6871.506 / 14.588, respectively. Conclusion the level of lipoprotein associated phospholipase A2 in patients with acute cerebral infarction at admission is an independent risk factor for poor short-term prognosis. Microemboli signal positive amplified the effect of high level lipoprotein associated phospholipase A 2 on the short term poor prognosis. Lipoprotein associated phospholipase A 2 / microemboli signal was a predictor of poor short-term prognosis of acute cerebral infarction in atherosclerotic type.
【作者單位】： 江蘇省南通市第一人民醫(yī)院神經(jīng)內(nèi)科;
【分類號(hào)】：R743.3

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