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[血清脂蛋白相关磷脂酶A2与缺血性卒中后血管性痴呆的关联]

[Association of serum lipoprotein-associated phospholipase A2 with vascular dementia after ischemic stroke].

作者信息

Zhang Q L, Lu P, Zhang J W

机构信息

Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou 450000, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2018 Apr 17;98(15):1171-1175. doi: 10.3760/cma.j.issn.0376-2491.2018.15.010.

Abstract

To study the relationship of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) with vascular dementia (VD) after ischemic stroke. A total of 226 ischemic stroke patients who visited the People's Hospital of Zhengzhou University from June.2013 to Oct.2016 were included and divided into the VD group and the non-dementia group according to the degree of cognitive impairment.The non-dementia group were further divided into the normal cognition group and the vascular cognitive impairment no dementia(VCIND) group.The general information of all patients were collected and the serum Lp-PLA2, Hcy, hs-CRP and the blood lipid indexes were detected.The Logistic regression model was built to analyze the association of Lp-PLA2 with the VD, correlation analysis and ROC curve were conducted to analyze the correlation of Lp-PLA2 with the state of cognitive impairment and to generate the cutoff value respectively. The serum Lp-PLA2 in VD group[(221±84) ng/ml] was significant higher than the non-dementia group[(133±60) ng/ml], the Lp-PLA2 in VCIND group[(148±65) ng/ml] was significant higher than the normal cognition group[(114±48) ng/ml](<0.05). The result of Logistic regression showed that Lp-PLA2 was a significant risk factor of VD[((95%)=1.015(1.010-1.021)], and its level was negatively correlated with the score of cognitive function.The cutoff value of Lp-PLA2 between the VD and non-dementia was 164.65 ng/ml and was 120.8 ng/ml between the normal cognition group and VCIND group. Lp-PLA2 is a significant risk factor of VD after ischemic stroke.

摘要

研究血清脂蛋白相关磷脂酶A2(Lp-PLA2)与缺血性脑卒中后血管性痴呆(VD)的关系。纳入2013年6月至2016年10月在郑州大学人民医院就诊的226例缺血性脑卒中患者,根据认知障碍程度分为VD组和非痴呆组。非痴呆组进一步分为正常认知组和血管性认知障碍无痴呆(VCIND)组。收集所有患者的一般资料,检测血清Lp-PLA2、同型半胱氨酸(Hcy)、高敏C反应蛋白(hs-CRP)及血脂指标。建立Logistic回归模型分析Lp-PLA2与VD的关联,进行相关性分析和ROC曲线分析,分别分析Lp-PLA2与认知障碍状态的相关性并得出临界值。VD组血清Lp-PLA2[(221±84)ng/ml]显著高于非痴呆组[(133±60)ng/ml],VCIND组Lp-PLA2[(148±65)ng/ml]显著高于正常认知组[(114±48)ng/ml](P<0.05)。Logistic回归结果显示,Lp-PLA2是VD的显著危险因素[比值比(95%可信区间)=1.015(1.010-1.021)],其水平与认知功能评分呈负相关。VD与非痴呆组之间Lp-PLA2的临界值为164.65 ng/ml,正常认知组与VCIND组之间为120.8 ng/ml。Lp-PLA2是缺血性脑卒中后VD的显著危险因素。

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