中国卒中杂志2025，Vol.20Issue(6)：718-727,10.DOI:10.3969/j.issn.1673-5765.2025.06.007
颈动脉脉搏波传导速度及血清Lp-PLA2、NRG-1与伴高血压的急性缺血性卒中的关系
The Relationship between Carotid Pulse Wave Velocity,Serum Lp-PLA2,NRG-1,and Acute Ischemic Stroke with Hypertension
摘要
Abstract
Objective To investigate the relationship between carotid pulse wave velocity(PWV),serum lipoprotein-associated phospholipase(Lp-PL)A2,and neuregulin-1(NRG-1)with large artery atherosclerosis(LAA)-type acute ischemic stroke(AIS)with hypertension. Methods AIS patients with hypertension admitted to the Hebei Medical University Third Hospital from August 2022 to August 2024 were prospectively and consecutively included as the study group,and patients with hypertension alone were selected as the control group.The baseline data of patients in the study group and the control group were compared.The logistic regression model was used for multivariate analysis of hypertension combined with AIS.In the study group,patients were divided into mild(NIHSS score＜5),moderate(5≤NIHSS score≤ 15),and severe(NIHSS score＞15)groups based on neurological deficits,as classified by NIHSS score.The baseline data of patients in the three groups were then compared.The Pearson correlation coefficient was used to analyze the correlation between pulse wave velocity at the beginning of systole(PWV-BS),pulse wave velocity at the end of systole(PWV-ES),Lp-PLA2,NRG-1,and NIHSS score.The logistic regression model was used for multivariate analysis of the severity of neurological deficit in AIS patients with hypertension. Results A total of 172 AIS patients with hypertension were included in the study group and 103 patients with hypertension alone were included in the control group.The multivariate analysis of logistic regression model showed that the levels of Lp-PLA2(OR 1.031,95％CI 1.017-1.045,P＜0.001),PWV-BS(OR 1.947,95％CI 1.232-3.079,P=0.004),and PWV-ES(OR 2.218,95％CI 1.567-3.138,P＜0.001)in the study group were higher than those in the control group,while the level of NRG-1(OR 0.994,95％CI0.990-0.997,P＜0.001)was lower than that in the control group.Among the 172 AIS patients with hypertension in the study group,there were 68 patients in the mild group,81 patients in the moderate group,and 23 patients in the severe group.Pearson correlation analysis showed that PWV-BS(r=0.631,P＜0.001),PWV-ES(r=0.599,P＜0.001),and Lp-PLA2(r=0.489,P＜0.001)were positively correlated with NIHSS score,while NRG-1 was negatively correlated with NIHSS score(r=-0.485,P＜0.001).Multivariate analysis of the logistic regression model showed that the duration of hypertension in the moderate and severe groups(OR 40.469,95％CI2.915-561.898,P=0.006;OR 160.155,95％CI 10.357-2476.616,P＜0.001),Lp-PLA2(OR 1.154,95％CI 1.039-1.282,P=0.007;OR 1.191,95％CI 1.069-1.328,P=0.002),PWV-BS(OR 23.275,95％CI 1.135-477.237,P=0.041;OR 79.267,95％CI 3.158-1989.561,P=0.008),and PWV-ES(OR 99.259,95％CI 3.367-2926.000,P=0.008;OR 203.017,95％CI 6.212-6634.497,P=0.003)were higher than those in the mild group,while the level of NRG-1(OR 0.980,95％CI0.964-0.996,P=0.014;OR 0.975,95％CI 0.957-0.993,P=0.007)was lower than that in the mild group. Conclusions PWV-BS,PWV-ES,and Lp-PLA2 levels were significantly higher and NRG-1 level was significantly lower in AIS patients with hypertension.The duration of hypertension,and the levels of Lp-PLA2,PWV-BS,PWV-ES and NRG-1 were related to the severity of neurological deficits in AIS patients with hypertension.关键词
缺血性卒中/高血压/颈动脉脉搏波传导速度/血清脂蛋白相关磷脂酶A2/神经调节蛋白-1Key words
Ischemic stroke/Hypertension/Carotid pulse wave velocity/Serum lipoprotein-associated phospholipase A2/Neuregulin-1分类
医药卫生引用本文复制引用
王赟,米亚儒,邓荷萍,张博..颈动脉脉搏波传导速度及血清Lp-PLA2、NRG-1与伴高血压的急性缺血性卒中的关系[J].中国卒中杂志,2025,20(6):718-727,10.基金项目
河北省医学科学研究课题计划(20230714) （20230714）
