急性缺血性脑卒中患者血清脂蛋白(a)水平及临床意义

目的研究急性缺血性脑卒中患者血清脂蛋白(a)水平及其与短期预后的关系。方法检测210 例急性缺血性脑卒中患者以及100 名性别和年龄匹配的健康人血清脂蛋白(a)水平。患者入院后行美国国立卫生研究院卒中量表(NIHSS)评定。出院时行改良Rankin 量表(mRS)评定。结果患者组血清脂蛋白(a)水平显著高于健康人(P<0.001)。调整其他危险因素后，血清脂蛋白(a)水平是mRS 的独立预测因素(P<0.001)。接受者操作特征曲线下面积分析，脂蛋白(a)和NIHSS 联合模型的预测准确度高于NIHSS 评分。结论急性缺血性脑卒中患者血清脂蛋白(a)水平升高。血清脂蛋白(a)水平是急性缺血性脑卒中短期预后的独立预测因素。

Significance of Serum Lipoprotein(a) in Patients with Acute Ischemic Stroke

Objective To investigate the serum lipoprotein (Lp) (a) level in patients with acute ischemic stroke and the prediction for short-term functional outcome. Methods The levels of serum Lp(a) were measured in 210 patients with acute ischemic stroke (within 24 h after onset) and 100 healthy people matched the gender and age. The patients were assessed with National Institutes of Health Stroke Scale (NIHSS) as admission, and modified Rankin Scale (mRS) as discharge. Results The median of Lp(a) was 325 mg/L (IQR: 180~545) in patients,significantly more than 148 mg/L (IQR: 69~265) in the normal controls (P<0.001). Level of serum Lp(a) was an independent variable for functional outcome (OR=1.004, 95%CI: 1.001~1.007, P<0.001) and death (OR=1.006, 95%CI: 1.001~1.008, P<0.001) in patients. In the receiver operating characteristic curve, the area under curve was more in the combined model Lp(a) and NIHSS] than the NIHSS alone.Conclusion Serum Lp(a) increased in the in patients with acute ischemic stroke, and may predict the short-term outcome independently.