血清UA、CysC、Lp-PLA2与急性脑梗死合并脑白质疏松症患者预后的关系研究

摘要 目的：探讨血清尿酸（UA）、胱抑素C（CysC）、脂蛋白相关磷脂酶 A2（Lp-PLA2）水平与急性脑梗死合并脑白质疏松症患者预后的关系。方法：选择2020年3月至2022年12月中国人民解放军联勤保障部队第九六0医院收治的113例急性脑梗死合并脑白质疏松症患者，检测血清UA、CysC、Lp-PLA2水平。随访1个月，根据改良Rankin量表（mRS）评分将患者分为预后良好组（0～2分，75例）和预后不良组（3分及以上，38例）。多因素Logistic回归分析急性脑梗死合并脑白质疏松症患者预后不良的危险因素，受试者工作特征曲线（ROC）分析血清UA、CysC、Lp-PLA2对急性脑梗死合并脑白质疏松症患者预后不良的预测价值。结果：预后不良组血清UA、CysC、Lp-PLA2水平高于预后良好组（P＜0.05）。多因素Logistic回归分析显示重度脑白质病变、高入院时NIHSS评分，高血清UA、CysC、Lp-PLA2水平是急性脑梗死合并脑白质疏松症患者预后不良的危险因素（P＜0.05）。联合血清UA、CysC、Lp-PLA2预测急性脑梗死合并脑白质疏松症患者预后的曲线下面积（AUC）为0.916，高于单独预测。结论：急性脑梗死合并脑白质疏松症患者血清UA、CysC、Lp-PLA2水平增高且与预后不良有关，联合血清UA、CysC、Lp-PLA2预测急性脑梗死合并脑白质疏松症患者预后不良价值较高。

Study on the Relationship between Serum UA, CysC, Lp-PLA2 and Prognosis of Patients with Acute Cerebral Infarction Complicated with Leukoaraiosis

ABSTRACT Objective: To explore the relationship between the levels of serum uric acid (UA), cystatin C (CysC) and lipoprotein-associated phospholipase A2 (Lp-PLA2) and prognosis of patients with acute cerebral infarction complicated with leukoaraiosis. Methods: 113 patients with acute cerebral infarction complicated with leukoaraiosis admitted to the 960 Hospital of Joint Logistics Support Force of Chinese People''s Liberation Army from March 2020 to December 2022 were selected, the levels of serum UA, CysC and Lp-PLA2 were detected. Followed up for 1 month, the patients were divided into good prognosis group (0 ~ 2 scores, 75 cases) and poor prognosis group (3 scores and above, 38 cases) according to the modified Rankin Scale (mRS) score. Multivariate Logistic regression was used to analyze the risk factors of poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis, and receiver operating characteristic curve (ROC) was used to analyze the value of serum UA, CysC and Lp-PLA2 in predicting poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis. Results: The levels of serum UA, CysC, and Lp-PLA2 in the poor prognosis group were higher than those in the good prognosis group (P<0.05). Multivariate Logistic regression analysis showed that severe white matter lesions, high NIHSS score at admission, and high levels of serum UA, CysC, and Lp-PLA2 were risk factors for poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis (P<0.05). The area under the curve (AUC) of combined serum UA, CysC, and Lp-PLA2 to predict the prognosis of patients with acute cerebral infarction complicated with leukoaraiosis was 0.916, which was higher than the individual prediction. Conclusion: The elevated levels of serum UA, CysC, and Lp-PLA2 in patients with acute cerebral infarction complicated with leukoaraiosis were associated with poor prognosis, the combination of serum UA, CysC, and Lp-PLA2 had a higher predictive value for poor prognosis in patients with acute cerebral infarction complicated with leukoaraiosis.