摘要
目的检测老年急性脑梗死患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、钙调蛋白(CaM)、水通道蛋白1(AQP1)水平,并探讨其与预后的关系。方法回顾性分析2021年2月至2022年2月于北京中医药大学孙思邈医院就诊的104例老年急性脑梗死患者的临床资料,依据入院后美国国立卫生研究院卒中(NHISS)量表评分进行分组,其中重度组23例,中度组43例,轻度组38例;采用改良Rankin(mRS)量表评估所有患者3个月后预后情况,并依据评分分组,其中预后不佳组37例,预后良好组67例,比较不同神经功能缺损程度患者血清Lp-PLA2、CaM、AQP1水平,应用Spearman相关性分析老年急性脑梗死患者血清Lp-PLA2、CaM、AQP1水平与神经功能缺损程度的相关性,采用多因素Logistic回归分析探究老年急性脑梗死患者预后不佳的影响因素。结果重度组患者的Lp-PLA2、CaM、AQP1水平分别为(328.24±84.26)U/L、(227.59±61.34)ng/mL、(44.51±8.26)μg/L,明显高于中度组的(264.56±61.44)U/L、(150.17±44.38)ng/mL、(35.19±5.98)μg/L和轻度组的(201.83±55.12)U/L、(83.24±20.14)ng/mL、(24.32±3.48)μg/L,且中度组患者的Lp-PLA2、CaM、AQP1水平明显高于轻度组,差异均有统计学意义(P<0.05);经Spearman相关性分析显示,老年急性脑梗死患者Lp-PLA2、CaM、AQP1水平与神经功能缺损程度均呈正相关性(P<0.05);预后不佳组与预后良好组患者的性别、年龄、身体质量指数(BMI)、基础疾病等资料比较差异均无统计学意义(P>0.05),但预后不佳组患者的NIHSS评分为(16.58±3.51)分,明显高于预后良好组的(14.24±2.35)分,血清Lp-PLA2、CaM、AQP1水平分别为(273.84±53.26)U/L、(174.69±48.65)ng/mL、(41.32±6.88)μg/L,明显高于预后良好组的(211.56±51.89)U/L、(130.43±38.55)ng/mL、(32.64±3.72)μg/L,差异均具有统计学意义(P<0.05);经多因素Logistic回归分析显示,血清Lp-PLA2、CaM、AQP1水平为老年急性脑梗死患者预后不佳的危险因素(P<0.05)。结论伴随老年急性脑梗死神经功能缺损程度加重,患者血清Lp-PLA2、CaM、AQP1水平均会出现升高现象;且血清Lp-PLA2、CaM、AQP1为老年急性脑梗死患者预后不佳的危险因素,值得临床重视。
Objective To detect serum lipoprotein associated phospholipase A2(Lp-PLA2),calmodulin(CaM),and aquaporin 1(AQP1)levels in elderly patients with acute cerebral infarction,and investigate their relation ship with the prognosis.Methods The clinical data of 104 elderly patients with acute cerebral infarction treated in Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine from February 2021 to February 2022 were analyzed retrospectively.According to the National Institutes of Health Stroke Scale(NHISS)scores after admission,the patients were divided into the severe group(23 cases),the moderate group(43 cases),and the mild group(38 cases).According to the modified Rankin scale(mRS)score,the patients were divided into the poor prognosis group(37 cases)and the good prognosis group(67 cases).Serum Lp-PLA2,CaM,and AQP1 levels in elderly patients with different degrees of neurological impairment were compared.Spearman correlation analysis was conducted to discuss the relationship between serum Lp-PLA2,CaM and AQP1 levels and the degree of neurological impairment in elderly patients with acute cerebral infarction.Logistic regression analysis was performed to identify the influencing factors of poor prognosis in elderly patients with acute cerebral infarction.Results The levels of Lp-PLA2,CaM,and AQP1 in the severe group were(328.24±84.26)U/L,(227.59±61.34)ng/mL,and(44.51±8.26)μg/L,which were significantly higher than(264.56±61.44)U/L,(150.17±44.38)ng/mL,and(35.19±5.98)μg/L in the moderate group,and(201.83±55.12)U/L,(83.24±20.14)ng/mL,and(24.32±3.48)μg/L in the mild group(P<0.05).Spearman correlation analysis showed that the levels of Lp-PLA2,CaM,and AQP1 were positively correlated with the degree of neurological impairment(P<0.05).There was no statistically significant difference between the poor prognosis group and the good prognosis group in terms of gender,age,body mass index(BMI),and underlying diseases(P>0.05).The NIHSS score in the poor prognosis group was(16.58±3.51)points,which was significantly higher than(14.24±2.35)points in the good prognosis group,and serum Lp-PLA2,CaM,and AQP1 levels were(273.84±53.26)U/L,(174.69±48.65)ng/mL,and(41.32±6.88)μg/L,significantly higher than(211.56±51.89)U/L,(130.43±38.55)ng/mL,and(32.64±3.72)μg/L in the good prognosis group,with statistically significant difference(P<0.05).Multivariate logistic regression analysis showed that serum Lp-PLA2,CaM,and AQP1 levels were risk factors for poor prognosis of elderly patients with acute cerebral infarction(P<0.05).Conclusion With the aggravation of neurological impairment in elderly patients with acute cerebral infarction,serum Lp-PLA2,CaM,and AQP1 levels increase,which are risk factors for poor prognosis of elderly patients with acute cerebral infarction and deserve attention in clinical practice.
作者
张恒
杨燕
冯丹宁
王佩
王祝青
马娟娟
雷华斌
马亚如
叶青
王慧
ZHANG Heng;YANG Yan;FENG Dan-ning;WANG Pei;WANG Zhu-qing;MA Juan-juan;LEI Hua-bin;MA Ya-ru;YE Qing;WANG Hui(Department of Laboratory,Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine,Tongchuan 727031,Shaanxi,CHINA;Department of Brain Disease,Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine,Tongchuan 727031,Shaanxi,CHINA)
出处
《海南医学》
CAS
2024年第3期353-357,共5页
Hainan Medical Journal
基金
陕西省中医药管理局项目(编号:SZY-NLTL-2022-042)。
关键词
急性脑梗死
老年
脂蛋白相关磷脂酶A2
钙调蛋白
水通道蛋白1
预后
Acute cerebral infarction
Elderly
Lipoprotein associated phospholipase A2
Calmodulin
Aquaporin 1
Prognosis
