血清 Lp-PLA2 联合 MPO 在大动脉粥样硬化性脑梗死诊断中的价值。
The value of serum Lp-PLA2 combined with MPO in the diagnosis of cerebral infarction caused by large artery atherosclerosis.
机构信息
Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China.
Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China.
出版信息
Clin Neurol Neurosurg. 2023 Sep;232:107899. doi: 10.1016/j.clineuro.2023.107899. Epub 2023 Jul 16.
OBJECTIVE
To explore the value of serum lipoprotein-associated phospholipase A2（Lp-PLA2）combined with myeloperoxidase（MPO）for the diagnosis of large artery atherosclerosis(LAA) cerebral infarction.
METHODS
Baseline data were collected from patients with first-ever acute cerebral infarction, serum Lp-PLA2 and MPO levels were measured. The etiology of cerebral infarction was classified according to the Chinese Ischemic Stroke Subtype Classification Standard. The risk factors associated with LAA cerebral infarction were identified by univariate and multivariate regression analysis. The diagnostic value of serum Lp-PLA2 and MPO for LAA cerebral infarction was assessed by the area under the receiver-operating characteristic (ROC) curve.
RESULTS
Overall 368 patients were involved, 148 patients (40.22 %) were LAA. The serum La-PLA2 and MPO levels were higher in the LAA group than those in non-LAA group (23.06 ± 3.39 ng/mL versus 17.48 ± 3.26 ng/mL; 93.60 ± 9.58 ng/mL versus 75.98 ± 15.53 ng/mL; P < 0.001 for both). Multivariate analysis showed that elevated levels of serum Lp-PLA2 (OR 1.742, 95 %CI 1.499-2.025; P < 0.001) and MPO (OR 1.060, 95 % CI 1.026-1.096; P = 0.001) were the independent risk factors of LAA cerebral infarction. The area under curve of the serum Lp-PLA2 combined with MPO for the diagnosis of LAA cerebral infarction was 0.896 [0.866 ∼ 0.927] (P < 0.001).
CONCLUSION
Serum Lp-PLA2 combined with MPO could be valued as a predictor of acute cerebral infarction caused by large artery atherosclerosis.
目的
探讨血清脂蛋白相关磷脂酶 A2（Lp-PLA2）联合髓过氧化物酶（MPO）对大动脉粥样硬化（LAA）性脑梗死的诊断价值。
方法
收集首次急性脑梗死患者的基线资料，检测血清 Lp-PLA2 和 MPO 水平。根据中国缺血性脑卒中亚型分类标准对脑梗死病因进行分类。采用单因素和多因素回归分析确定与 LAA 脑梗死相关的危险因素。通过受试者工作特征（ROC）曲线下面积评估血清 Lp-PLA2 和 MPO 对 LAA 脑梗死的诊断价值。
结果
共纳入 368 例患者，其中 148 例（40.22%）为 LAA 患者。LAA 组患者血清 La-PLA2 和 MPO 水平高于非-LAA 组（23.06±3.39ng/ml 比 17.48±3.26ng/ml；93.60±9.58ng/ml 比 75.98±15.53ng/ml；均 P<0.001）。多因素分析显示，血清 Lp-PLA2 水平升高（OR=1.742，95%CI 1.4992.025；P<0.001）和 MPO 水平升高（OR=1.060，95%CI 1.0261.096；P=0.001）是 LAA 脑梗死的独立危险因素。血清 Lp-PLA2 联合 MPO 对 LAA 脑梗死的诊断曲线下面积为 0.896[0.866~0.927]（P<0.001）。
结论
血清 Lp-PLA2 联合 MPO 可作为大动脉粥样硬化性急性脑梗死的预测指标。
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