Relationship between serum lipoprotein-related phospholipase A2 and angiotensin 1-7 levels and vascular dementia in elderly patients with acute cerebral infarction
CHU Jingxin1 WANG Yu2▲ LI Baoshan1 JIANG Yi1 LIN Qiumei1
1.Department of General Practice, Chongqing University Central Hospital Chongqing Emergency Medical Center, Chongqing 400014, China;
2.Clinical Skills Training Center, Chongqing University Central Hospital Chongqing Emergency Medical Center, Chongqing 400014, China
Abstract：Objective To investigate the relationship between serum lipoprotein-related phospholipase A2 (Lp-PLA2) and angiotensin 1-7 (Ang1-7) levels and vascular dementia (VaD) in elderly patients with acute cerebral infarction (ACI). Methods A total of 122 ACI patients admitted to Chongqing University Central Hospital from May 2018 to May 2020 were selected as study objects. They were divided into ACI-VaD group (54 cases) and ACI-NVaD group (68 cases) according to whether VaD was combined; according to clinical dementia rating scale, ACI-VaD group was divided into mild dementia group (13 cases), moderate dementia group (16 cases), and severe dementia group (25 cases). The serum Lp-PLA2 and Ang1-7 levels in each group were compared, the multivariate logistic regression analysis was used to analyze the influencing factors of VaD in elderly patients with ACI, and the ROC curve was used to analyze the predictive value of serum Lp-PLA2 and Ang1-7 levels in ACI complicated with VaD. Results There were statistically significant differences in serum total cholesterol, high density lipoprotein cholesterol, high-sensitivity C-reactive protein (hs-CRP), Lp-PLA2 and Ang1-7 between two groups (P < 0.05). The level of serum Lp-PLA2 in severe dementia group was higher than that in moderate dementia group and mild dementia group, and the level of serum Ang1-7 was lower than that in moderate dementia group and mild dementia group; the level of serum Lp-PLA2 in moderate dementia group was higher than that in mild dementia group, and the level of serum Ang1-7 in moderate dementia group was lower than that in mild dementia group, with statistical significance (all P < 0.05). Hs-CRP and Lp-PLA2 were independent risk factors for VaD in elderly patients with ACI (OR ＞ 1, P ＜ 0.05), Ang1-7 was an independent protective factor (OR ＜ 1，P ＜ 0.05). The area under the curve, sensitivity, specificity and accuracy of Lp-PLA2+Ang1-7 predicting elderly patients with ACI complicated with VaD were greater than those of Lp-PLA2 and Ang1-7 alone. Conclusion Serum Lp-PLA2 level is significantly increased and Ang1-7 level is significantly decreased in elderly ACI patients complicated with VAD, which are independent influencing factors for VAD, and combined detection could enhance the predictive value of VAD.
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