LPA、Hcy、MCP-1与缺血性脑卒中患者神经损伤和侧支循环的关系

目的探讨缺血性脑卒中患者血清溶血磷脂酸(LPA)、同型半胱氨酸(Hcy)、单核细胞趋化蛋白-1(MCP-1)水平与神经功能缺损程度及侧支循环形成的关系。方法选取2017年3月至2020年8月本医院神经内科收治的缺血性脑卒中患者108例为研究组,按照2∶1比例选择同期54例健康体检者作为对照组。检测所有患者和健康者的血清LPA、Hcy、MCP-1水平,分析缺血性脑卒中患者血清LPA、Hcy、MCP-1水平与NIHSS评分的相关性,采取受试者工作曲线(ROC)分析血清LPA、Hcy、MCP-1对侧支循环良好的预测价值,记录曲线下面积(AUC值)。结果研究组患者血清LPA、Hcy、MCP-1水平明显高于对照组,差异有统计学意义(P<0.05)。各亚组间患者血清LPA、Hcy、MCP-1水平比较,轻度损伤组<中度损伤组<重度损伤组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,血清LPA、Hcy、MCP-1水平与NIHSS评分呈显著正相关(P<0.05)。侧支循环良好组血清LPA、Hcy、MCP-1水平明显低于侧支循环不良组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,血清LPA、Hcy、MCP-1预测侧支循环良好的AUC值分别为0.834、0.847、0.858,敏感度分别为71.43%、80.36%、87.50%。结论缺血性脑卒中患者血清LPA、Hcy、MCP-1高表达,三者均能反映神经功能缺损程度,或可作为判断侧支循环形成是否良好的生物学指标。

Relationship between LPA,Hcy and MCP?1 and neurological injury and collateral circu?lation in patients with ischemic stroke

Objective To investigate the relationship between levels of serum lysophosphatidic ac?id(LPA),homocysteine(Hcy)and monocyte chemoattractant protein?1(MCP?1)and neurological deficit de?gree and collateral circulation formation in patients with ischemic stroke.Methods 108 patients with ischemic stroke admitted to the Department of this Hospital between March 2017 and August 2020 were selected as the study group,and another 54 healthy people with physical examination during the same period were selected as the control group according to a 2∶1 ratio.The levels of serum LPA,Hcy and MCP?1 were detected among all patients and healthy people.The correlation between levels of serum LPA,Hcy and MCP?1 and NIHSS score was analyzed among patients with ischemic stroke,and receiver operating characteristic curve(ROC)was used to analyze the predictive value of serum LPA,Hcy and MCP?1 on good collateral circulation,and the ar?ea under the curve(AUC value)was recorded.Results The levels of serum LPA,Hcy and MCP?1 in pa?tients with ischemic stroke were significantly higher than those in healthy people(P<0.05).Comparison of serum LPA,Hcy and MCP?1 levels among patients in each subgroup showed that the mild injury group