Study On The Correlation Between Serum Lipoprotein-associated Phospholipase A 2,Homocysteine Level And Acute Cerebral Infarction

ObjectiveTo investigate the relationship between serum Lp-PLA2,homocysteine level and ACI,and further to study the relationship between Lp-PLA2 level and neurological deficit and infarct volume,which provides a new target for the prevention,treatment and prognosis of ACI.MethodsA total of 146 patients with acute cerebral infarction treated in the Department of Neurology of the affiliated Central Hospital of Shenyang Medical College from October 2019 to January 2021 were selected as the observation group.The infarct volume was calculated by Pullicino formula.The observation group was divided into small volume group,medium volume group and large volume group according to the infarct volume.The National Institutes of Health Stroke Scale(NIHSS)divided the observation group into a light group,a moderate group and a severe group.The Control Group recruited 100 health examinees.The general clinical data,such as sex,age,history of diabetes,hypertension,coronary heart disease,etc,and laboratory routine biochemical indexes such as triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),high sensitive C-reaction protein(hs-CRP),uric acid(UA)were collected.The levels of serum lipoprotein associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)were measured.The differences in serum Lp-PLA2,Hcy,hs-CRP and UA levels between the observation and control groups were compared.The Logistic regression analysis was used to further explore the relationship between ACI and Lp-PLA2 and Hcy,etc.The changes in serum Lp-PLA2,Hcy,hs-CRP and UA levels between large volume group,medium volume group,small volume group were analysed as well as the differences of the mild group,moderate group and severe group were further analyzed.Spearman correlation analysis was used to evaluate the correlation of serum Lp-PLA2,Hcy,hs-CRP and UA levels with NIHSS score and infarct volume.The ROC working curve was drawn to learn the evaluation power of serum Lp-PLA2 and Hcy levels on the risk of ACI.ResultsThe serum levels of Lp-PLA2,Hcy,hs-CRP and UA in the observation group were significantly higher than those in the control group(P< 0.01).The Logistic regression analysis indicated that Lp-PLA2(OR: 1.015)and Hcy(OR: 1.187)were risk factors for ACI.The levels of Lp-PLA2,Hcy,hs-CRP and UA in light group were lower than those in moderate and severe group,and those in moderate group were lower than those in severe group,and the differences are statistically significant(P < 0.05).The serum levels of Lp-PLA2,Hcy,hs-CRP and UA in small volume group were lower than those in large volume group and middle volume group,and those in middle volume group was lower than the large volume group,and there were significant difference between each of the three groups(P < 0.05).Spearman correlation analysis showed that there was a positive correlation between serum Lp-PLA2 level and NIHSS score(rs = 0.645,P < 0.01),infarct volume(rs = 0.574,P < 0.01).After adjusting for other confounding factors,Lp-PLA2 and Hcy remained risk factors for ACI.The ROC working curve shows that the AUC values of serum Lp-PLA2 and Hcy for ACI risk assessment are 0.737 and 0.675,respectively;the AUC value of Lp-PLA2 and Hcy combined detection for ACI was 0.760,which is greater than the efficacy of the two alone.Conclusions1.Serum Lp-PLA2 and Hcy levels were significantly related to ACI and were risk factors for ACI.2.The detection of Serum Lp-PLA2 level may play a reference role in the assessment of patients with ACI.3.The serum levels of LP-PLA2 and Hcy may be used as indicators to assess the risk of ACI.The combined detection of LP-PLA2 and Hcy may play a further warning role in the occurrence of ACI.