血清脂蛋白(a)作为急性缺血性卒中溶栓后早期神经功能恶化的预测因素
Serum Lipoprotein(a) as Predictive Factor for Early Neurological Deterioration of Acute Ischemic Stroke After Thrombolysis.
作者信息
Wang Ruiming, Kong Weiguo, Zhang Wenhua
机构信息
Department of Neurology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, People's Republic of China.
出版信息
Int J Gen Med. 2024 Aug 31;17:3791-3798. doi: 10.2147/IJGM.S475767. eCollection 2024.
OBJECTIVE
This study aimed to explore the relationship between serum lipoprotein(a) (LP(a)) levels and early neurological deterioration (END) in patients with acute ischemic stroke (AIS) after thrombolysis.
METHODS
In total, 236 patients with AIS after thrombolysis were enrolled in this study. Serum LP(a) levels were measured on admission after thrombolysis. END was defined as an increase of at least two points in the NIHSS score within 48 hours after thrombolysis. Binary logistic regression analysis was used to assess the association between serum LP(a) levels and END.
RESULTS
Overall, patients with END had higher LP(a) than those without END (high LP(a): 38.3% vs 22.2%, intermediate LP(a): 40.3% vs 41.8%, low LP(a): 21.3% vs 36.0%, p<0.005). In the multivariate analysis, high LP(a) (defined as LP(a) level 300 mg/L) was an independent risk factor for END post-thrombolysis (OR=3.154, 95% CI=1.067-9.322, p=0.038).
CONCLUSION
Our findings demonstrated that LP(a) was an independent risk factor for END post-thrombolysis and that LP(a) level 300 mg/L could be associated with END post-thrombolysis in this study population.
目的
本研究旨在探讨急性缺血性卒中（AIS）患者溶栓后血清脂蛋白（a）[LP（a）]水平与早期神经功能恶化（END）之间的关系。
方法
本研究共纳入236例溶栓后的AIS患者。溶栓后入院时测定血清LP（a）水平。END定义为溶栓后48小时内美国国立卫生研究院卒中量表（NIHSS）评分至少增加2分。采用二元逻辑回归分析评估血清LP（a）水平与END之间的关联。
结果
总体而言，发生END的患者LP（a）水平高于未发生END的患者（高LP（a）：38.3%对22.2%，中LP（a）：40.3%对41.8%，低LP（a）：21.3%对36.0%，p<0.005）。多因素分析中，高LP（a）（定义为LP（a）水平≥300 mg/L）是溶栓后END的独立危险因素（OR=3.154，95%CI=1.067-9.322，p=0.038）。
结论
我们的研究结果表明，LP（a）是溶栓后END的独立危险因素，在本研究人群中，LP（a）水平≥300 mg/L可能与溶栓后END相关。
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