作　　者： ; ; ; ; ;

机构地区： 汕头大学医学院

出　　处： 《实用心脑肺血管病杂志》 2017年第10期32-36,共5页

摘　　要： 目的分析血清脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)及尿酸(UA)水平与青年脑梗死患者神经功能缺损程度及复发的关系。方法选取2014年1月—2016年6月汕头大学医学院附属粤北医院收治的青年脑梗死患者88例,根据美国国立卫生研究院卒中量表(NIHSS)评分分为轻度神经功能缺损者41例(NIHSS评分≤7分,A组)、中度神经功能缺损者30例(8分≤NIHSS评分≤13分,B组)及重度神经功能缺损者17例(NIHSS评分≥14分,C组);另选取同期体检健康者42例作为对照组。比较4组受试者一般资料和实验室检查指标,比较有无脑梗死复发患者血清Lp-PLA2、Hcy、UA水平;血清Lp-PLA2、Hcy、UA水平与青年脑梗死患者NIHSS评分的相关性分析采用Pearson相关性分析,绘制ROC曲线以评价血清Lp-PLA2、Hcy、UA水平对青年脑梗死患者复发的预测价值。结果 4组受试者性别、年龄、高血压发生率、高脂血症发生率、糖尿病发生率比较,差异均无统计学意义(P>0.05)。4组受试者血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平比较,差异无统计学意义(P>0.05);A、B、C组患者血清C反应蛋白(CRP)、纤维蛋白原(FIB)、Lp-PLA2、Hcy、UA水平高于对照组,B、C组患者血清CRP、FIB、Lp-PLA2、Hcy、UA水平高于A组,C组患者血清CRP、FIB、Lp-PLA2、Hcy、UA水平高于B组(P<0.05)。随访1年出现脑梗死复发者38例,未复发者50例。脑梗死复发者血清Lp-PLA2、Hcy、UA水平均高于脑梗死未复发者(P<0.05)。Pearson相关性分析结果显示,血清Lp-PLA2(r=0.468)、Hcy(r=0.473)、UA(r=0.418)水平与青年脑梗死患者NIHSS评分呈正相关(P<0.05)。ROC曲线显示,血清Lp-PLA2、Hcy、UA水平预测青年脑梗死患者复发的曲线下面积(AUC)分别为0.723、0.783、0.805。结论血清Lp-PLA2、Hcy、UA水平与青年脑梗死患者神经功能缺损程度有关,且对脑梗死复发具有一定预测价值。 Objective To analyze the correlations of serum levels of Lp-PLA2,Hcy and UA with degree of nervous functional defects and recurrence of cerebral infarction in young people. Methods A total of 88 young patients with cerebral infarction were selected in North Guangdong Hospital Affiliated to Medical College of Shantou University from January 2014 to June 2016,and they were divided into A group [with mild nervous functional defects（ NIHSS equal or less than 7）,n = 41],B group [with moderate nervous functional defects（ NIHSS score equal or over 8 but equal or less than 13）,n = 30 ] and C group [with severe nervous functional defects（ NIHSS score equal or over 14）, n = 17 ]; meanwhile a total of 42 patients admitted to this hospital for physical examination were selected as control group. General information and laboratory examination results were compared among the four groups,serum levels of Lp-PLA2,Hcy and UA were compared in patients with or without recurrence of cerebral infarction; Pearson correlation analysis was used to analyze the correlations of serum levels of Lp-PLA2,Hcy and UA with NIHSS in young patients with cerebral infarction,ROC curve was drawn to evaluate the predictive value of serum levels of Lp-PLA2,Hcy and UA on recurrence of cerebral infarction in young people. Results No statistically significant differences of gender,age,incidence of hypertension,hyperlipidaemia or diabetes was found between the two groups（ P〈0. 05）. No statistically significant differences of serum level of TC,TG,LDL or HDL was found among the four groups（ P〈0. 05）; serum levels of CRP,FIB,Lp-PLA2,Hcy and UA of A group,B group and C group were statistically significantly higher than those of control group,serum levels of CRP,FIB,Lp-PLA2,Hcy and UA of B group and C group were statistically significantly higher than those of A group,meanwhile serum levels of CRP, FIB, Lp-PLA2, Hcy and UA of C group were statistically significantly higher than those of B group（ P〈0. 05）. During the 1-year follow-up

关 键 词： 脑梗死 青年人 脂蛋白相关磷脂酶 同型半胱氨酸 尿酸 复发

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