Objective: To study the relationship of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) with vascular dementia (VD) after ischemic stroke. Methods: A total of 226 ischemic stroke patients who visited the People's Hospital of Zhengzhou University from June.2013 to Oct.2016 were included and divided into the VD group and the non-dementia group according to the degree of cognitive impairment.The non-dementia group were further divided into the normal cognition group and the vascular cognitive impairment no dementia(VCIND) group.The general information of all patients were collected and the serum Lp-PLA2, Hcy, hs-CRP and the blood lipid indexes were detected.The Logistic regression model was built to analyze the association of Lp-PLA2 with the VD, correlation analysis and ROC curve were conducted to analyze the correlation of Lp-PLA2 with the state of cognitive impairment and to generate the cutoff value respectively. Results: The serum Lp-PLA2 in VD group[(221±84) ng/ml] was significant higher than the non-dementia group[(133±60) ng/ml], the Lp-PLA2 in VCIND group[(148±65) ng/ml] was significant higher than the normal cognition group[(114±48) ng/ml](P<0.05). The result of Logistic regression showed that Lp-PLA2 was a significant risk factor of VD[(OR(95%CI)=1.015(1.010-1.021)], and its level was negatively correlated with the score of cognitive function.The cutoff value of Lp-PLA2 between the VD and non-dementia was 164.65 ng/ml and was 120.8 ng/ml between the normal cognition group and VCIND group. Conclusion: Lp-PLA2 is a significant risk factor of VD after ischemic stroke.
目的： 探讨血清脂蛋白相关磷脂酶A2(Lp－PLA2)与缺血性脑卒中后血管性痴呆(VD)的相关性。 方法： 收集2013年6月至2016年10月在郑州大学人民医院就诊的缺血性脑卒中患者226例，根据认知功能障碍程度分为VD组(104例)和非痴呆组(122例)，并将非痴呆组分为认知正常组(54例)和非痴呆性认知功能障碍(VCIND)组(68例)。统计所有患者一般资料，并测定血清Lp－PLA2、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs－CRP)及血脂指标。建立Logistic回归模型分析Lp－PLA2是否为VD的危险因素，而后利用相关性及ROC曲线分析Lp－PLA2与认知障碍病情的相关性以及诊断界限值。 结果： VD组血清Lp－PLA2水平[(221±84) ng/ml]显著高于非痴呆组[(133±60) ng/ml]，VCIND组Lp－PLA2[(148±65) ng/ml]高于认知正常组[(114±48 ) ng/ml]，差异有统计学意义(P<0.05)；Logistic回归分析结果表明，血清Lp－PLA2是与VD密切相关的危险因素[OR(95%CI)＝1.015(1.010～1.021)]，且其水平与认知功能评分呈负相关；Lp－PLA2水平在VD组和非痴呆组间的界限值为164.65 ng/ml，认知正常组和VCIND组间的界限值为120.8 ng/ml。 结论： 血清Lp－PLA2是缺血性脑卒中后VD发生的相关危险因素。.
Keywords: Ischemic stroke; Lipoprotein-associated phospholipase A2; Logistic regression; Risk factors; Vascular dementia.