进展性脑梗死患者血清LPA、D-D水平变化及其意义-现代医学

进展性脑梗死患者血清LPA、D-D水平变化及其意义

单位：重庆市大足区人民医院神经内科, 重庆 402360

分类号：R743.3

出版年·卷·期（页码）：2021·49·第四期（424-428）

摘要：

目的：分析进展性脑梗死患者血清溶血磷脂酸（LPA）、D-二聚体（D-D）水平的变化及其意义。方法：急性脑梗死患者99例均来源于我院门诊2015年2月至2018年1月收治的病例，分为进展性脑梗死组（n=41）与非进展性脑梗死组（n=58），同期健康体检者30例作为对照组，对照组体检当日采血，脑梗死患者于入院时、入院24 h、入院48 h采血，测定血清LPA、D-D水平，分析LPA、D-D水平对进展性脑梗死的早期预测价值及两者与进展性脑梗死神经功能损害的关系。结果：非进展性脑梗死、进展性脑梗死患者血清LPA、D-D水平均高于对照组（P<0.05），进展性脑梗死组入院不同时间点LPA、D-D水平又高于非进展性脑梗死组（P<0.05）；进展性脑梗死组入院48 h NIHSS评分及入院时、入院48 h NIHSS评分差值均高于非进展性脑梗死组（P<0.05）；D-D水平＞447.10μg·L^-1时预测进展性脑梗死曲线下面积为0.811，敏感性、特异性分别为87.50%、77.97%；LPA水平＞6.57 μmol·L^-1时预测敏感性、特异性分别为77.50%、94.92%；进展性脑梗死患者血清LPA、D-D水平与NIHSS评分呈正相关（P<0.05）。结论：进展性脑梗死患者血清LPA、D-D水平较非进展性脑梗死患者高，且与患者神经功能受损程度密切相关，可作为早期预测脑梗死进展及病情变化的依据。

Objective: To analyze the significance of changes of serum lysophosphatidic acid (LPA) and D-dimer (D-D) levels in patients with progressive cerebral infarction. Methods: A total of 99 patients with acute cerebral infarction who were treated in the hospital from February 2015 to January 2018 were divided into progressive cerebral infarction group (n=41) and non-progressive cerebral infarction group (n=58). Meanwhile, 30 healthy subjects were selected as the control group. Blood samples of the control group were collected on the day of physical examination and those of patients with acute cerebral infarction were collected at admission, 24 h and 48 h after admission to measure serum LPA and D-D levels. Value of LPA and D-D levels in early prediction of progressive cerebral infarction, the relationship between the two and neurological impairment of progressive cerebral infarction were analyzed. Results: Serum LPA and D-D levels in patients with cerebral infarction were higher than those in the control group (P<0.05). Besides, LPA and D-D levels in progressive cerebral infarction group were higher than those in non-progressive cerebral infarction group at different time points after admission (P<0.05). The NIHSS score of progressive cerebral infarction group was higher than that of non-progressive cerebral infarction group at 48 h after admission, and difference value of the NIHSS score between 48 h after admission and admission of progressive cerebral infarction group was also higher (P<0.05). When the D-D level was higher than 447.10 μg·L^-1, the area under the curve for prediction of progressive cerebral infarction was 0.811, and the sensitivity and specificity were 87.50% and 77.97%. When the LPA was higher than 6.57 μmol·L^-1, the predictive sensitivity and specificity were 77.50% and 94.92%. Serum LPA and D-D levels in patients with progressive cerebral infarction were positively correlated with the NIHSS score (P<0.05). Conclusion: Serum LPA and D-D levels in patients with progressive cerebral infarction are higher than those in patients with non-progressive cerebral infarction, which are closely related to the degree of neurological impairment and can be used for early prediction of cerebral infarction progression and changes in patients' condition.

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