本文關(guān)鍵詞： 脂蛋白相關(guān)磷脂酶A2 缺血性腦卒中 動脈粥樣硬化 炎癥　出處：《青島大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：應(yīng)用酶聯(lián)免疫吸附法測定缺血性腦卒中患者血清Lp-PLA2的水平變化,探討血清Lp-PLA2水平與臨床各型缺血性腦卒中以及缺血性腦卒中的其他危險因素之間的關(guān)系,明確其在缺血性卒中發(fā)病中的作用。 方法：采用隨機對照研究,觀察組為2012年8月-2013年8月青島大學(xué)醫(yī)學(xué)院附屬醫(yī)院急診神經(jīng)科收治入院的100例缺血性腦卒中患者,對照組為性別、年齡與觀察組患者匹配的50例健康體檢者。其中,觀察組所有患者均為第一次發(fā)病且均未服用抗凝及降脂藥物。兩組患者均于入院24小時內(nèi)空腹取靜脈血測定血糖、血脂[甘油三酯(TRIG)、膽固醇(CHOL)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)]、 Lp-PLA2、血漿超敏C反應(yīng)蛋白(hs-CRP)水平,記錄患者吸煙史、血壓、神經(jīng)功能缺損程度(NIHSS評分)、缺血性腦卒中類型(大動脈粥樣硬化型、小動脈閉塞型、心源性栓塞型)等指標,所有數(shù)據(jù)用SPSS17.0軟件進行統(tǒng)計分析。 結(jié)果：1.觀察組患者血清Lp-PLA2水平高于對照組,獨立樣本t檢驗示差異有顯著性(P0.01)。Logistic回歸分析示Lp-PLA2是缺血性腦卒中的危險因素。 2.多元線性回歸分析示：觀察組Lp-PLA2水平與患者NIHSS評分呈正相關(guān)且具有多元線性關(guān)系(P0.05),與患者hs-CRP、血壓、血脂、血糖水平無明顯相關(guān)性(P0.05)。 3.大動脈粥樣硬化型卒中組(LAA)和小動脈閉塞型卒中組(SAA)分別與對照組相比血清Lp-PLA2水平差異有統(tǒng)計學(xué)意義(P0.05)。心源性腦栓塞組(CE)與對照組相比血清Lp-PLA2水平差異無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論：1.高水平Lp-PLA2是缺血性腦卒中的危險因素,檢測血清Lp-PLA2水平可評估缺血性腦卒中的患病風(fēng)險。 2.血清Lp-PLA2水平能反映缺血性腦卒中患者神經(jīng)功能缺損程度,但與缺血性腦卒中的其它危險因素之間無明顯相關(guān)性。 3. Lp-PLA2在不同類型缺血性腦卒中人群中的相關(guān)性不同。
[Abstract]:Objective: to study the relationship between serum Lp-PLA2 level and other risk factors in patients with ischemic stroke by enzyme linked immunosorbent assay (Elisa). To clarify its role in the pathogenesis of ischemic stroke. Methods: a randomized controlled study was conducted in which 100 patients with ischemic stroke were admitted to the Department of Emergency Neurology, affiliated Hospital of Qingdao University Medical College from August 2012 to August 2013, and the control group was gender. All the patients in the observation group were diagnosed for the first time and did not take anticoagulant and lipid-lowering drugs. Serum lipids [triglyceride triglyceride triglyceride, cholesterol choll, high density lipoprotein cholesterol (HDL-CU), low density lipoprotein cholesterol (LDL-C)], Lp-PLA2, plasma hypersensitive C-reactive protein hs-CRP) levels, smoking history and blood pressure were recorded. The degree of neurological impairment was evaluated by NIHSS, the types of ischemic stroke (arteriosclerosis, arteriole occlusion, cardiogenic embolism). All the data were statistically analyzed by SPSS17.0 software. Results 1. The serum Lp-PLA2 level in the observation group was higher than that in the control group, and the independent sample t test showed that Lp-PLA2 was the risk factor of ischemic stroke. 2.Multivariate linear regression analysis showed that the Lp-PLA2 level in the observation group was positively correlated with the patients' NIHSS score and had a multivariate linear relationship (P 0.05), but had no significant correlation with the patients' hs-CRP, blood pressure, blood lipids and blood glucose levels. 3. There was significant difference in serum Lp-PLA2 level between large artery atherosclerotic stroke group and small artery occlusive stroke group (P 0.05). There was no significant difference in serum Lp-PLA2 level between cardiogenic cerebral embolism group and control group. Conclusion High level of Lp-PLA2 is a risk factor for ischemic stroke. Detection of serum Lp-PLA2 level can evaluate the risk of ischemic stroke. 2. The level of serum Lp-PLA2 can reflect the degree of neurological deficit in patients with ischemic stroke, but there is no significant correlation between the level of serum Lp-PLA2 and other risk factors of ischemic stroke. 3. The correlation of Lp-PLA2 in different types of ischemic stroke was different.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

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