脂蛋白相关磷脂酶A2与缺血性脑卒中的相关性研究

发布时间：2018-02-24 23:07

本文关键词： 脂蛋白相关磷脂酶A2 缺血性脑卒中动脉粥样硬化炎症　出处：《青岛大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：应用酶联免疫吸附法测定缺血性脑卒中患者血清Lp-PLA2的水平变化,探讨血清Lp-PLA2水平与临床各型缺血性脑卒中以及缺血性脑卒中的其他危险因素之间的关系,明确其在缺血性卒中发病中的作用。方法：采用随机对照研究,观察组为2012年8月-2013年8月青岛大学医学院附属医院急诊神经科收治入院的100例缺血性脑卒中患者,对照组为性别、年龄与观察组患者匹配的50例健康体检者。其中,观察组所有患者均为第一次发病且均未服用抗凝及降脂药物。两组患者均于入院24小时内空腹取静脉血测定血糖、血脂[甘油三酯(TRIG)、胆固醇(CHOL)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、 Lp-PLA2、血浆超敏C反应蛋白(hs-CRP)水平,记录患者吸烟史、血压、神经功能缺损程度(NIHSS评分)、缺血性脑卒中类型(大动脉粥样硬化型、小动脉闭塞型、心源性栓塞型)等指标,所有数据用SPSS17.0软件进行统计分析。结果：1.观察组患者血清Lp-PLA2水平高于对照组,独立样本t检验示差异有显著性(P0.01)。Logistic回归分析示Lp-PLA2是缺血性脑卒中的危险因素。 2.多元线性回归分析示：观察组Lp-PLA2水平与患者NIHSS评分呈正相关且具有多元线性关系(P0.05),与患者hs-CRP、血压、血脂、血糖水平无明显相关性(P0.05)。 3.大动脉粥样硬化型卒中组(LAA)和小动脉闭塞型卒中组(SAA)分别与对照组相比血清Lp-PLA2水平差异有统计学意义(P0.05)。心源性脑栓塞组(CE)与对照组相比血清Lp-PLA2水平差异无统计学意义(P0.05)。结论：1.高水平Lp-PLA2是缺血性脑卒中的危险因素,检测血清Lp-PLA2水平可评估缺血性脑卒中的患病风险。 2.血清Lp-PLA2水平能反映缺血性脑卒中患者神经功能缺损程度,但与缺血性脑卒中的其它危险因素之间无明显相关性。 3. Lp-PLA2在不同类型缺血性脑卒中人群中的相关性不同。
[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.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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