Predictive value of serum lipoprotein-associated phospholipase A 2for the outcome in patients with large atherosclerotic stroke
10.3760/cma.j.issn.1673-4165.2018.08.002
- VernacularTitle:血清脂蛋白相关磷脂酶A2预测大动脉粥样硬化性卒中患者转归的价值
- Author:
Shanhua YU
1
;
Jiandong JIANG
;
Qinghong ZENG
;
Haojiang ZHANG
Author Information
1. 222000,连云港市第二人民医院神经内科
- Keywords:
Stroke;
Brain Ischemia;
Arteriosclerosis;
Treatment Outcome;
Phospholipases A 2;
Biomarkers;
Risk Factors
- From:
International Journal of Cerebrovascular Diseases
2018;26(8):566-570
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of serum lipoprotein-associated phospholipase A2(Lp-PLA2) for the outcomes in patients with large atherosclerotic stroke (LAA). Methods Patients with LAA admitted to the Second People's Hospital of Lianyungang from March 2015 to January 2018 were enrolled retrospectively. The outcomes were evaluated by the modified Rankin Scale at 90 d after onset, 0-2 was defined as good outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for poor outcome. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of Lp-PLA2for outcomes. Results A total of 121 patients with LAA were enrolled, including 64 males (52.9%) and 57 females (47.1%), aged 63.5 ±9.5 years; 72 (59.5%) had good outcome and 49 (40.5%) had poor outcome. The differences were statistically significant in the proportion of diabetic patients (26.4% vs.65.3%; χ2=18.110, P<0.001) and glycated hemoglobin ( 6.39% ±2.33% vs. 7.58% ±3.12%; t=1.663, P=0.041), baseline National Institutes of Health Stroke Scale (NIHSS) score (5 [3-6] vs.10[7 -14]; Z= -7.498, P< 0.001), and Lp-PLA2(194.7 ±84.3 μg/L vs.291.4 ± 82.6 μg/L; t= -5.447, P<0.001) between the good outcome group and the poor outcome group. Multivariate logistic regression analysis showed that diabetes ( odds ratio [ OR] 1.215, 95% confidence interval [CI] 1.102-1.601; P=0.046), glycosylated hemoglobin ( OR 2.275, 95% CI 1.065-4.865; P=0.037), baseline NIHSS score ( OR 2.113, 95% CI 1.585-2.734; P=0.015), and Lp-PLA2(OR 5.183, 95% CI 3.203-8.134; P<0.001) were the independent risk factors for poor outcomes in patients with LAA. ROC analysis showed that the area under the curve of Lp-PLA2predicting poor outcome was 0 .792 (95% CI 0.713-0.872); the optimal cut-off value was 260.5 μg/L, the sensitivity for predicting poor outcome was 79.6%, and the specificity was 84.7%. Conclusion The higher serum Lp-PLA2level is an independent predictive factor for poor outcome in patients with LAA. It has a higher predictive value for poor outcome.
