MPO和Lp-PLA2与急性缺血性脑卒中严重程度的相关性及对早期预后的评估价值OACSTPCD

Objective To investigate whether myeloperoxidase(MPO)and lipoprotein-associated phospholipase A2(Lp-PLA2)can be used as serum markers to assess the severity and early prognosis of acute ischemic stroke(AIS).Methods Totally 145 patients with AIS who were treated in the Peace Hospital Affiliated to Changzhi Medical College from June 2020 to December 2021 were collected.The patients were divided into the good prognosis group(mRS≤2 points,80 cases)and the poor prognosis group(mRS>2 points,65 cases)according to the modified mRS score 3 months after discharge.The general baseline data and laboratory test indicators of patients upon admission were collected,and enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of MPO and Lp-PLA2.Pearson correlation analysis was used to detecte the correlation between MPO and Lp-PLA2 and NIHSS score.Logistic multivariate regression independent risk factors affecting the early poor prognosis of AIS,ROC curve was used to auclyze the predictive value of NIHSS score,cerebral infarction volume,MPO and Lp-PLA2 on the early poor prognosis of AIS.Results In the poor prognosis group,National Institutes of Health stroke scale(NIHSS)score,creatine kinase isoenzyme(CK-MB),troponin T(TnT),troponin I(TnI),C-reactive protein(CRP),MPO and Lp-PLA2 were higher than those of the good prognosis group,and there were statistical differences between the groups(P<0.05).MPO and Lp-PLA2 levels were positively correlated with NIHSS score(r= 0.835,0.796,P<0.001).NIHSS score(OR=2.521,95%CI:1.414-3.950,P=0.015),cerebral infarction volume(OR= 1.965,95%CI:1.042-3.014,P=0.009),MPO(OR=3.695,95%CI:1.362-5.263,P<0.001)and Lp-PLA2(OR=2.154,95%CI:1.063-5.217,P<0.001)were independent risk factors for the early prognosis of AIS.The predictive value of MPO for the early poor prognosis of AIS was higher than the NIHSS score and cerebral infarction volume(Z=3.514,P= 0.020;Z=3.865,P=0.008),and the predictive value of Lp-PLA2 for the early poor prognosis of AIS was higher than the NIHSS score,cerebral infarction volume(Z=3.625,P=0.018;Z=4.014,P=0.005),MPO and Lp-PLA2 had no statistically significant difference in the predictive value of early poor prognosis of AIS(Z=1.025,P=0.109).Conclusion TMPO and Lp-PLA2 are expressed at high levels in patients with poor prognosis of AIS,which are positively correlated with the degree of nerve damage,and related to poor early prognosis of patients.They are expected to be serum markers for assessing the severity of AIS and poor early prognosis.