Correlation analysis of serum lipoprotein a, lipoprotein-associated phospholipase A2, and clinical prognosis in patients with metabolic syndrome complicated with ischemic stroke treated with intravenous thrombolytic therapy
Abstract Objective To investigate the correlation between serum lipoprotein a (Lp[a]), lipoprotein-associated phospholipase A2 (LP-PLA2), and clinical prognosis in patients with metabolic syndrome complicated with ischemic stroke treated with intravenous thrombolytic therapy. Methods A total of 107 patients with metabolic syndrome combined with hyperacute ischemic stroke admitted to Linfen Central Hospital of Shanxi Province from January 2020 to March 2022 were selected as the study objects. All patients received intravenous thrombolytic therapy with Alteplase after completing routine examination. Clinical data and Lp[a] and LP-PLA2 tests were collected. According to the changes of the National Institutes of Health stroke scale at admission and seven days after admission, the patients were divided into a recent improvement group (67 cases) and a recent no improvement group (40 cases), and according to the changes of the modified Rankin scale score at admission and 90 days after admission, the patients were divided into a long-term improvement group (72 cases) and a long-term no improvement group (35 cases). The clinical data and the differences of Lp[a] and LP-PLA2 were compared respectively, and the influencing factors of recent and long-term prognosis were analyzed, and the predictive value of the influencing factors was further analyzed. Results The levels of total cholesterol, triglyceride, low density lipoprotein, Lp[a], and LP-PLA2 in recent no improvement group were higher than those in recent improvement group (P＜0.05). The levels of total cholesterol, low density lipoprotein, Lp[a], and LP-PLA2 in the long-term no improvement group were higher than those in the long-term improvement group (P＜0.05). Logistic regression analysis showed that low-density lipoprotein (OR=1.073, 95%CI: 1.011-1.734), Lp[a] (OR=1.833, 95%CI: 1.631-2.341), LP-PLA2 (OR=1.725, 95%CI: 1.237-2.113) were the influencing factors of recent prognosis in patients with metabolic syndrome complicated with ischemic stroke treated with intravenous thrombolytic therapy (P＜0.05); Lp[a] (OR=1.743, 95%CI: 1.531-2.293), and LP-PLA2 (OR=1.685, 95%CI: 1.106-2.131) were the factors influencing the long-term prognosis of patients with metabolic syndrome complicated with ischemic stroke treated with intravenous thrombolytic therapy (P＜ 0.05). Lp[a] and LP-PLA2 could predict the recent and long-term prognosis of patients with metabolic syndrome complicated with ischemic stroke (P＜0.05). Conclusion Serum Lp[a] and LP-PLA2 levels in patients with metabolic syndrome complicated with intravenous thrombolysis of ischemic stroke have an influence on the near and long term prognosis, and have a certain prognostic value, which is worthy of attention in clinical work.
