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在中国人群中,按性别分层的脂蛋白相关磷脂酶 A2 水平与缺血性卒中复发风险的相关性。

Correlation between plasma lipoprotein-associated phospholipase A2 levels and risk of ischaemic stroke recurrence by gender in the Chinese population.

机构信息

Department of Clinical Laboratory, The Second People's Hospital of Foshan, Foshan, Guangdong, China.

Department of Clinical Laboratory, The First People's Hospital of Foshan, Foshan, Guangdong, China.

出版信息

Neurol Res. 2024 Jul;46(7):679-689. doi: 10.1080/01616412.2024.2340886. Epub 2024 Apr 11.

Abstract

OBJECTIVE

To investigate the correlation between gender differences in plasma lipoprotein phospholipase A2 (Lp-PLA2) levels and the risk of recurrent stroke in patients with acute ischaemic stroke in China.

METHODS

We conducted a prospective follow-up study that included baselineLp-PLA2 levels and NIH Stroke Scale (NIHSS) scores in patients with ischaemic stroke upon admission. The diagnostic efficacy of the baseline Lp-PLA2 level for stroke recurrence was evaluated. And Kaplan‒Meier method was used to analyse the difference in the risk of recurrent stroke between these two groups among males and females. A paired t test was used to analyse the difference in Lp-PLA2 levels in male and female patients after follow-up.

RESULTS

Baseline plasma Lp-PLA2 was higher in men and women with recurrent stroke than in those without recurrent stroke. The correlation between baseline Lp-PLA2 and neurological impairment was higher in female than male stroke patients ( = 0.338 and 0.253, respectively). Although weakly correlated with neurological impairment, baseline Lp-PLA2 was more effective in predicting recurrent stroke (AUC = 0.705 in men, 0.788 in women). A Cox model was used to compare the risk of stroke between the high- and low-Lp-PLA2 groups (OR = 3.98 in men, 2.61 in women). According to the follow-up time of 6 months as the node, Lp-PLA2 will give different risk indicators.

CONCLUSION

Elevated plasma Lp-PLA2 is an independent risk factor for recurrent ischaemic stroke but is not strongly associated with the degree of cerebral damage. The predictive value of baseline Lp-PLA2 for stroke recurrence risk was higher in females than in males.

摘要

目的

探讨中国急性缺血性脑卒中患者血浆脂蛋白磷脂酶 A2(Lp-PLA2)水平的性别差异与复发性卒中风险的相关性。

方法

我们进行了一项前瞻性随访研究,纳入了入院时缺血性脑卒中患者的基线 Lp-PLA2 水平和美国国立卫生研究院卒中量表(NIHSS)评分。评估了基线 Lp-PLA2 水平对卒中复发的诊断效能。并采用 Kaplan-Meier 法分析了男性和女性两组患者复发性卒中风险的差异。采用配对 t 检验分析了随访后男性和女性患者 Lp-PLA2 水平的差异。

结果

复发性卒中患者的基线血浆 Lp-PLA2 水平高于无复发性卒中患者。基线 Lp-PLA2 与女性卒中患者的神经功能损伤相关性高于男性(=0.338 和 0.253)。尽管与神经功能损伤弱相关,但基线 Lp-PLA2 对复发性卒中的预测更有效(男性 AUC=0.705,女性 AUC=0.788)。Cox 模型用于比较高低 Lp-PLA2 组之间的卒中风险(男性 OR=3.98,女性 OR=2.61)。根据 6 个月的随访时间作为节点,Lp-PLA2 会给出不同的风险指标。

结论

升高的血浆 Lp-PLA2 是复发性缺血性卒中的独立危险因素,但与脑损伤程度的相关性不强。基线 Lp-PLA2 对女性卒中患者复发性卒中风险的预测价值高于男性。

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