The Clinical Significance Of Serum Lipoprotein-related Phospholipase A2 Levels And High-resolution Magnetic Resonance Imaging In Acute Ischemic Stroke

Objective:Through high-resolution magnetic resonance imaging(HRMRI)and serum lipoprotein-related phospholipase A2(Lp-PLA2)levels in patients with acute ischemic stroke,the nature of carotid plaque and serum Lp-PLA2 levels are analyzed for acute deficiency.The clinical significance of hemorrhagic stroke(AIS)provides a basis for individualized prevention and treatment of AIS.Methods:Seventy cases of large atherosclerotic AIS patients who were hospitalized in the Department of Neurology of Hunan Brain Hospital from May 2019 to December 2020 were selected as the research group.Based on the results of head CT/magnetic resonance examinations,the study group was divided into large atherosclerosis Baseline data and serum Lp-PLA2 levels were compared between the initial group and the relapsed group of AIS.According to the results of HRMRI,the study group was divided into carotid artery stable plaque group and vulnerable plaque group.The levels of serum Lp-PLA2 in the two groups were analyzed and related factors affecting the recurrence of large atherosclerotic AIS were analyzed.According to the National Institutes of Health Stroke Scale(NIHSS),the study group was divided into a mild group(NIHSS score ?4 points)and a moderate group(NIHSS score between 5-15 points).)And severe group(NIHSS score?16 points),compare the serum Lp-PLA2 levels of the three groups.Results:1.The comparison of statistical baseline data and the results of multivariate Logistic regression analysis suggested that age,LDL,Lp-PLA2 and carotid artery vulnerable plaque are the influencing factors for the recurrence of large atherosclerotic AIS(P<0.05).Serum Lp-PLA2 in the recurrence group was(1 84.47±42.14)higher than that in the initial group(155.03±45.27),and the difference was statistically significant(P<0.05).The ROC curve analysis results indicated that the area under the curve for Lp-PLA2 to predict the recurrence of large atherosclerotic AIS was 0.847,and the difference was statistically significant(P<0.05).The sensitivity of Lp-PLA2 is 69%and the specificity is 89.3%.2.The serum Lp-PLA2 level(181.80±33.92)of the carotid artery vulnerable plaque group in the study group was higher than that of the stable plaque group(133.62 ± 48.57),and the difference was statistically significant(P<0.05).3.Pearson correlation analysis indicated that there was a strong positive correlation between the severity of NIHSS score and Lp-PLA2 in the study group(r=0.769,P<0.05).One-way analysis of variance showed that the Lp-PLA2 level of patients with mild disease in the study group(117.68±39.02)was lower than that of moderate patients(158.31 ±23.93),and the Lp-PLA2 level of the latter was lower than that of severe patients(196.63±30.81),(all P<0.05).Conclusion:1.Serum Lp-PLA2 and carotid artery vulnerable plaque are the influencing factors for the recurrence of large atherosclerotic AIS.2.The higher the level of serum Lp-PLA2,the more serious the neurological deficit of large atherosclerotic AIS.