急性脑梗死患者ICAM-1、sLOX-1、Lp-PLA2水平及临床意义

Correlation Analysis of Serum ICAM-1, sLOX-1, and Lp-PLA2 Levels with Prognosis in Patients with Acute Cerebral Infarction

摘要

目的 探究急性脑梗死（ACI）患者血清细胞间黏附因子-1（ICAM-1）、可溶性凝集素样氧化低密度脂蛋白受体-1（sLOX-1）、脂蛋白相关磷脂酶A2（Lp-PLA2）表达水平与预后相关性,并分析其对预后不良的预测价值。方法 回顾性选取2021年5月~2023年5月于郑州颐和医院诊治的104例ACI患者为研究对象,治疗后90 d依据改良Rankin量表（mRS）评估预后情况并将其分为预后不良组38例、预后良好组66例,比较其血清ICAM-1、sLOX-1、Lp-PLA2水平。多因素Logistic回归分析预后的影响因素。评价治疗后1个月血清ICAM-1、sLOX-1、Lp-PLA2对预后不良的预测价值。结果 预后不良组治疗后1个月血清ICAM-1、sLOX-1、Lp-PLA2水平高于预后良好组（P<0.05）;NIHSS评分、神经元特异性烯醇化酶（NSE）、中枢神经特异蛋白（S100-β）及治疗后1个月ICAM-1、sLOX-1、Lp-PLA2水平为预后不良的独立危险因素（P<0.05）;治疗后1个月ICAM-1、sLOX-1、Lp-PLA2水平联合预测预后不良的AUC大于单项指标预测、任意两项指标联合预测（P<0.05）。结论 ACI患者血清ICAM-1、sLOX-1、Lp-PLA2水平为预后不良的独立危险因素,联合检测其水平对预后情况具有一定预测价值。

Abstract

Objective To investigate the correlation between the expression levels of intercellular adhesion molecule-1 (ICAM-1), soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1), and lipoprotein-associated phospholipase A2 (Lp-PLA2) in serum of patients with acute cerebral infarction (ACI) and their prognosis, and to analyze their predictive value for poor prognosis. Methods A retrospective study was conducted on 104 ACI patients who were diagnosed and treated in Zhengzhou Yihe Hospital from May 2021 to May 2023. After treatment, the prognosis was evaluated based on the modified Rankin Scale (mRS) at 90 days, and the patients were divided into a poor prognosis group (n=38) and a good prognosis group (n=66). The serum levels of ICAM-1, sLOX-1, and Lp-PLA2 were compared between the two groups. The influencing factors of prognosis were analyzed by multivariate Logistic regression. To evaluate the predictive value of serum ICAM-1, sLOX-1 and Lp-PLA2 in poor prognosis 1 month after treatment. Results The levels of serum ICAM-1, sLOX-1, and Lp-PLA2 in the poor prognosis group were higher than those in the good prognosis group 1 month after treatment (P<0.05). NIHSS score, neuron-specific enolase (NSE), central nervous specific protein (S100-β) and ICAM-1, sLOX-1 and Lp-PLA2 levels one month after treatment were independent risk factors for poor prognosis (P<0.05). The AUC of ICAM-1, sLOX-1 and Lp-PLA2 combined predicted poor prognosis at 1 month after treatment was greater than that of single index and any two indexes combined (P<0.05). Conclusion The levels of serum ICAM-1, sLOX-1, and Lp-PLA2 in ACI patients are independent risk factors for poor prognosis, and combined detection of their levels has certain predictive value for prognosis.

关键词

急性脑梗死 / 预后 / 细胞间黏附因子-1 / 可溶性凝集素样氧化低密度脂蛋白受体-1 / 脂蛋白相关磷脂酶A2

Key words

acute cerebral infarction / prognosis / ICAM-1 / sLOX-1 / Lp-PLA2

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