血清脂蛋白相关磷脂酶A2、视椎蛋白样蛋白1、甲壳质酶蛋白40水平与CO中毒患者并发急性脑梗死相关

秦义亮.血清脂蛋白相关磷脂酶A2、视椎蛋白样蛋白1、甲壳质酶蛋白40水平与CO中毒患者并发急性脑梗死相关[J].内科急危重症杂志,2025,31(1):58-61

DOI：10.11768/nkjwzzzz20250110

英文关键词:

基金项目:衡水市科学技术局2022年度科技计划（ 2022014015Z）

作者	单位	E-mail
秦义亮	衡水市第四人民医院	ehcwua3c@163.com

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中文摘要:

摘要目的：探讨血清脂蛋白相关磷脂酶A2（LP-PLA2）、视椎蛋白样蛋白1（VILIP-1）、甲壳质酶蛋白40（YKL-40）水平与CO中毒（CMP）患者并发急性脑梗死（ACI）的相关性。方法：选取100例CMP患者，将CMP合并ACI的46例患者归为病例组，未合并ACI的54例患者归为对照组。比较2组一般资料，检测2组血清中LP-PLA2、VILIP-1、YKL-40的水平；采用多因素Logistic回归分析CMP患者发生ACI的影响因素；受试者工作特征（ROC）曲线分析血清LP-PLA2、VILIP-1、YKL-40水平对CMP患者发生ACI的预测价值。结果：病例组血清LP-PLA2、VILIP-1、YKL-40水平显著高于对照组（P均＜0.05）。多因素Logistic回归分析结果显示，血清LP-PLA2、VILIP-1、YKL-40水平是CMP患者发生ACI的影响因素（P均＜0.05）。血清LP-PLA2、VILIP-1、YKL-40三者联合预测CMP患者发生ACI的AUC为0.984，灵敏度为83.48%，特异性为98.15%，优于血清LP-PLA2、VILIP-1、YKL-40各自单独预测（Z二者联合-LP-PLA2=2.535、Z二者联合-VILIP-1=3.462、Z二者联合-YKL-40=3.886，P=0.011、0.001、0.000）。结论：CMP合并ACI患者血清LP-PLA2、VILIP-1、YKL-40水平显著上调，三者联合可较好地预测CMP患者ACI的发生。

英文摘要:

Abstract Objective: To investigate the correlation between the levels of serum lipoprotein-associated phospholipase A2(LP-PLA2), Opto-like protein 1 (VILIP-1), chitinase protein 40 (YKL-40) and acute cerebral infarction (ACI) in patients with carbon monoxide poisoning (CMP). Methods: A total of 100 CMP patients who were treated in our hospital from January 2021 to November 2022 were collected.According to the clinical characteristics of CMP with ACI, the ACI patients with CMP served as the case group (n=46), and the ACI patients without CMP were taken as the control group (n=54). The general data of the two groups were compared.The serum levels of LP-PLA2, VILIP-1 and YKL-40 in the two groups were detected.The multivariate Logistic regression was applied to analyze the influencing factors of the occurrence of ACI in CMP patients. The predictive value of serum LP-PLA2, VILIP-1 and YKL-40 levels on the occurrence of ACI in CMP patients was analyzed by the ROC curve. Results: The levels of serum LP-PLA2, VILIP-1 and YKL-40 in the case group were obviously higher than those in the control group (P< 0.05). Multivariate Logistic regression analysis showed that serum LP-PLA2, VILIP-1, YKL-40 levels were the influencing factors for the occurrence of ACI in CMP patients (P <0.05). The AUC of the combination of serum LP-PLA2, VILIP-1 and YKL-40 in predicting the occurrence of ACI in CMP patients was 0.984, the sensitivity was 83.48%, and the specificity was 98.15%, which was better than that of serum LP-PLA2, VILIP-1 and YKL-40 separately (Zcombination-LP-PLA2=2.535, Zcombination-VILIP-1=3.462, Zcombination-YKL-40=3.886, P=0.011, 0.001, 0.000). Conclusions: The serum levels of LP-PLA2, VILIP-1 and YKL-40 in ACI patients with CMP are obviously increased, and the combination of LP-PLA2, VILIP-1 and YKL-40 can better predict the occurrence of ACI in CMP patients.