血清脂蛋白(a)联合残余胆固醇对急性缺血性脑卒中病人短期预后的预测价值

    Predictive value of serum lipoprotein(a) combined with remnant cholesterol for short-term prognosis in patients with acute ischemic stroke

    • 摘要:
      目的 探讨血清脂蛋白(a) Lp(a)联合残余胆固醇(RC)对急性缺血性脑卒中(AIS)短期预后的预测价值。
      方法 回顾性收集278例AIS病人,对其发病3个月时进行随访,采用改良的Rankin量表(mRS)评分分为预后良好组188例(mRS评分>2分),预后不良组90例(mRS评分≤2分)。比较2组病人一般临床资料及Lp(a)、RC水平;分析Lp(a)、RC与病人预后的关系;采用Spearman法评价Lp(a)、RC与病人短期预后的相关性;绘制受试者工作特征曲线,分析Lp(a)、RC、Lp(a)联合RC对AIS病人短期预后的预测价值。
      结果 预后良好组Lp(a)、RC明显低于预后不良组(P<0.01)。logistic回归分析显示Lp(a)、RC与AIS病人短期功能预后独立相关(P<0.01)。Spearman相关性分析显示,Lp(a)、RC与AIS病人发病3个月时mRS评分呈正相关关系(P<0.01)。受试者工作特征曲线分析结果显示,相较于Lp(a)、RC、入院NIHSS评分,Lp(a)联合RC具有更高的预测价值,其曲线下面积为0.900,灵敏度为93.33%,特异度为75.53%。
      结论 Lp(a)联合RC对AIS病人短期功能预后的预测价值较高。

       

      Abstract:
      Objective To explore the predictive value of serum lipoprotein (a)Lp (a) combined with remnant cholesterol (RC) on the short-term prognosis of acute ischemic stroke (AIS).
      Methods A total of 278 AIS patients were retrospectively collected and followed up at 3 months after onset. Using the modified Rankin scale (mRS) score, 188 patients were enrolled in the good prognosis group (mRS score >2 points) and 90 patients were enrolled in the poor prognosis group (mRS score ≤2 points). The relationship between Lp(a), RC and patient prognosis was analyzed. Spearman method was used to evaluate the correlation between Lp(a), RC and short-term prognosis of patients. The receiver operating characteristic(ROC) curve was drawn, and the predictive value of Lp(a), RC, Lp(a) combined with RC for the short-term prognosis of AIS patients was analyzed.
      Results Lp (a) and RC in the good prognosis group were significantly lower than those in the poor prognosis group (P < 0.01). Logistic regression analysis showed that Lp(a) and RC were independently associated with the short-term functional prognosis of AIS patients (P < 0.01). Spearman correlation analysis showed that Lp(a), RC were positively correlated with mRS scores of AIS patients at 3 months after onset (P < 0.01). ROC curve analysis showed that compared with Lp(a), RC and admission NIHSS score, Lp(a) combined with RC had higher predictive value, with an area under the curve of 0.900, a sensitivity of 93.33% and a specificity of 75.53%.
      Conclusions The combination of Lp (a) and RC has a high predictive value for short-term functional prognosis in AIS patients.

       

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