Abstract：Objective: To explore the correlation between the expression levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), lipoprotein a [LP(a)], apolipoprotein B (ApoB)/apolipoprotein A-1 (ApoA-1) and the severity and prognosis of acute cerebral infarction (ACI). Methods: A total of 122 ACI patients admitted to our hospital from January 2022 to January 2023 were selected as the case group. According to the severity of the disease, they were divided into mild (54 cases), moderate (49 cases), and severe (19 cases) groups. Another 97 healthy individuals who underwent physical examinations during the same period were selected as the control group. According to the prognosis, the patients were divided into a good prognosis group (88 cases) and a poor prognosis group (34 cases). Differences in basic information and biochemical indicators between the case group and control group were compared, and the impact of the expression levels of Lp-PLA2, LP(a), and ApoB/ApoA-1 on the severity of the disease and prognosis was analyzed. Results: The age, smoking history, number of hypertension cases, systolic blood pressure, LDL-C, LP(a), and Lp-PLA2 levels in the case group were higher than those in the control group (P<0.05), while the HDL-C level was lower in the case group than in the control group (P<0.05). Multivariate logistic regression analysis indicated that age, smoking history, hypertension, systolic blood pressure, HDL-C, LDL-C, LP(a), Lp-PLA2, and ApoB/ApoA-1 were independent risk factors for ACI (P<0.05). The levels of Lp-PLA2, LP(a), and ApoB/ApoA-1 in the severe group were significantly higher than those in the mild and moderate groups (P<0.05), and the levels in the moderate group were significantly higher than those in the mild group (P<0.05). Spearman correlation analysis showed that the levels of Lp-PLA2, LP(a), and ApoB/ApoA-1 were positively correlated with the severity of the disease (r=0.796, 0.718, 0.451; P<0.05). The levels of Lp-PLA2, LP(a), and ApoB/ApoA-1 in the good prognosis group were significantly higher than those in the poor prognosis group (P<0.05). ROC curve analysis showed that the combined prediction AUC was 0.987. Conclusion: Elderly individuals, those with abnormal blood pressure and lipid levels, and those with poor lifestyle habits are more prone to ACI. The levels of Lp-PLA2, ApoB/ApoA-1 are significantly correlated with the severity and prognosis of ACI. Monitoring these levels can effectively assess the progression of the patient's condition and has high clinical value.
薛涵, 高静, 王冬静, 赵雪, 张艳利, 刘莉, 王利民, 刘有为. Lp-PLA2 LP(a) ApoB/ApoA-1水平与急性脑梗死严重程度及预后的相关性分析[J]. 河北医学, 2024, 30(5): 857-862.
XUE Han, GAO Jing, WANG Dongjing, et al. Analysis of the Correlation between Levels of Lp-PLA2 LP(a) ApoB/ApoA-1 and the Severity and Prognosis of Acute Cerebral Infarction. HeBei Med, 2024, 30(5): 857-862.
[1] 兰翠霞,王健,王江凤等.血清Lp-PLA2、RDW-CV、NLR值变化与急性脑梗死患者早期神经功能恶化及预后的关系[J].中国现代医学杂志,2023,33(10):12-17. [2] 郝佳佳,周沛萱,丘惠嫦.老年急性脑梗死患者并发脑微出血影响因素[J].中国老年学杂志,2022,42(21):5177-5180. [3] Shan Y,Tan S,Lin Y,et al.The glucagon-like peptide-1 receptoragonist reduces inflammation and blood-brain barrier breakdown in an astrocyte-dependent manner in experimental stroke[J].Neuroinflammation,2019,16(1):242. [4] Charbonnier G,Bonnet L,Bouamra B,et al.Does intravenous thrombolysis influence the time of recanalization and success of mechanical thrombectomy during the acute phase of cerebral infarction[J].Cerebrovasc Dis Extra,2020,10(1):28-35. [5] Fu Y,Zheng S,Kong H,et al.Clinical value of combined detection of UA and MMP-9 in evaluating bleeding transformation and prognosis after thrombolysis in acute cerebral infarction[J].Appl BiochemBiotechnol,2022,194(11):5236-5254. [6] 蔡智立,何奕涛,付学军等.急性脑梗死机械取栓后颅内出血转化的影响因素分析[J].暨南大学学报(自然科学与医学版),2021,42(3):314-319. [7] Qin X,Wang J,Chen S,et al.Astrocytic P75<sup>NTR</sup> expression provoked by ischemic stroke exacerbatesthe blood-brain barrier disruption[J].Glia,2022,70(5):892-912. [8] Liu J,Tian L,Li N.Treatment efficacy of arterial urokinase thrombolysiscombined with mechanical thrombectomy for acute cerebral infarction and itsinfluence on neuroprotective factors and factors for neurological injury[J].Am Transl Res,2021,13(4):3380-3389. [9] Zhong TT,Wang G,Wang XQ,et al.Serum calcium,albumin,globulin and matrix metalloproteinase-9 levels in acute cerebralinfarction patients[J].World Clin Cases,2021,9(30):9070-9076. [10] Lin YY,Guo SJ,Quan H,et al.Donepezil improves gait performance in patients with an acute cerebral Infarction:a prospective observational cohort study[J].Curr Neurovasc Res,2020,17(3):304-311. [11] Liu L,Luo GQ,Liu Q,et al.Hemorrhagic risk factors after rt PAthrombolysis in acute cerebral infarction[J].Eur Rev Med Pharmacol Sci,2023,27(12):5542-5551. [12] Mao X,Luan D,Qi Z.Dysregulation of serum miR-138-5p and its clinical significance in patients with acute cerebral infarction[J].Cerebrovasc Dis,2022,51(5):670-677. [13] Lin X,Wang W,Tao T,et al.Synthetic role of miR-411-5p andCT perfusion information in predicting clinical outcomes after thrombolysis inacute cerebral infarction[J].Acta Neurol Belg,2023,123(2):457-464. [14] Ha SH,Ryu JC,Bae JH,et al.Isolated pontine infarction versus pontineplus infarction:prevalence,pathogenic mechanism,and outcomes[J].Neurol,2022,269(8):4375-4382. [15] Pikija S,Magdic J,Sztriha LK,et al.Endovascular therapy for tandem occlusion in acute ischemic stroke:intravenous thrombolysis improves outcomes[J].Clin Med,2019,8(2):228. [16] Huang M,Li D,Li L,et al.Factors predictingthe occurrence of net adverse clinical and cerebral events in patients withacute coronary syndrome treated with clopidogrel or ticagrelor in combinationwith aspirin:a real-world study[J].Ann Transl Med.2022,10(2):98. [17] Mao L,Chen XH,Zhuang JH,et al.Relationship between β-amyloid protein 1-42,thyroid hormone levels and the riskof cognitive impairment after ischemic stroke[J].World Clin Cases,2020,8(1):76-87.
2024, Vol. 30 
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