血清β2-微球蛋白联合脂蛋白相关磷脂酶A2与卒中后认知障碍的相关性研究

doi:10.3969/j.issn.1003-9198.2022.01.007

摘要/Abstract

摘要： 目的探讨急性缺血性脑卒中(AIS)病人血清β2-微球蛋白(β2-MG)、脂蛋白相关磷脂酶A2(Lp-PLA2)与卒中后认知障碍的相关性。方法收集陕西省人民医院神经内科住院的AIS病人,于入院后次日检测空腹血清β2-MG、 Lp-PLA2、LDL-C、HDL-C等指标,常规治疗3 个月后行MoCA量表评估,并根据评分将病人分为卒中后认知障碍(PSCI)组(MoCA＜26分)和认知正常组(PSNCI组)(MoCA≥26分),比较2组临床资料特征,分析 PSCI发生的危险因素,绘制ROC曲线分析β2-MG、Lp-PLA2及联合检测对PSCI的预测价值及诊断阈值。结果共入组了符合标准的AIS病人102例,治疗3个月时PSCI的发生率为53.9%(55/102)。PSCI组病人的年龄、高血压比例、教育年限及血清β2-MG、Lp-PLA2水平均高于PSNCI组(P<0.05)。Logistic回归分析显示,血清β2-MG、Lp-PLA2水平升高是PSCI的重要危险因素(P<0.05)。β2-MG、Lp-PLA2及联合检测预测PSCI的AUC分别为0.654、0.790、0.872,敏感度分别为80.0%、78.2%、87.3%,特异度分别为66.0%、74.5%、80.8%。结论 AIS病人血清β2-MG、Lp-PLA2水平较高时,卒中后3个月更易发生认知障碍,这两个指标可作为PSCI的预测因子。

关键词: 认知障碍, β2-微球蛋白, 脂蛋白相关磷脂酶A2, 急性缺血性脑卒中

Abstract: Objective To explore the correlation of serum β2 microglobulin (β2-MG) and lipoprotein-related phospholipase A2(Lp-PLA2) with post-stroke cognitive impairment(PSCI) in the patients with acute ischemic stroke (AIS). Methods The AIS patients hospitalized in the Department of Neurology of Shaanxi Provincial People’s Hospital were recruited.Fasting serum levels of β2-MG,Lp-PLA2, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and other indicators were detected at admission.After 3 months of routine treatment,all the patients were divided into PSCI group (MoCA <26) and normal cognition group (MoCA≥26). Multi-variate Logistic regression analysis was performed to analyze the risk factors of PSCI. Finally, Receiver operating characteristic (ROC) curve analysis was carried out to determine the cut-off potint of β2-MG and Lp-PLA2. Results A total of 102 AIS patients were enrolled. The prevalence of PSCI after 3 months of routine treatment was 53.9% (55 cases). The age, the ratio of hypertension,years of education, the serum levels of Lp-PLA2 and β2-MG of the PSCI group were higher than those of the normal cognition group (P<0.05).Logistic regression analysis showed that serum levels of β2-MG, Lp-PLA2 were important risk factors for PSCI (P<0.05). The area under ROC curve of β2-MG,Lp-PLA2 and combined detection was 0.654,0.790, 0.872, with a sensitivity of 80.0%, 78.2%, 87.3%, and a specificity of 66.0%,74.5%, 80.8% respectively. Conclusions AIS patients with higher serum levels of β2-MG, Lp-PLA2 are more likely to occur PSCI 3 months after stroke. These index can be used as the predictors of PSCI.

Key words: cognitive impairment, β2 microglobulin, lipoprotein-related phospholipase A2, acute ischemic stroke

中图分类号:

R 749.1

张美妮, 李敏, 薛佳婧, 杨谦, 王涛. 血清β2-微球蛋白联合脂蛋白相关磷脂酶A2与卒中后认知障碍的相关性研究[J]. 实用老年医学, 2022, 36(1): 23-26.

ZHANG Mei-ni, LI Min, XUE Jia-jing, YANG Qian, WANG Tao. Correlation of serum β2 microglobulin and lipoprotein-associated phospholipase A2 with post-stroke cognitive impairment[J]. Practical Geriatrics, 2022, 36(1): 23-26.

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