河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (3): 343-347.doi: 10.3969/j.issn.1007-3205.2024.03.015

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老年H型高血压伴急性脑梗死患者TyG、LP-PLA2水平检测及临床意义

  

  1. 四川省达州市中心医院老年病科,四川 达州 635000

  • 出版日期:2024-03-25 发布日期:2024-04-07
  • 作者简介:李菊容(1978-),女,四川眉山人,四川省达州市中心医院副主任医师,医学学士,从事老年病诊治研究。
  • 基金资助:
    四川省科技计划项目(20YYJC1932)

Detection and clinical significance of triglyceride glucose index and LP-PLA2 level in elderly patients with H-type hypertension and acute cerebral infarction

  1. Department of Geriatrics, Dazhou Central Hospital, Sichuan Province, Dazhou 635000,  China

  • Online:2024-03-25 Published:2024-04-07

摘要: 目的 探讨老年H型高血压伴急性脑梗死(acute cerebral infarction,ACI)患者三酰甘油葡萄糖指数(triglyceride glucose,TyG)、血脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LP-PLA2)水平检测及临床意义。
方法 回顾性分析老年H型高血压伴ACI患者(研究组)97例、老年H型高血压患者(对照组)148例。比较2组临床资料及TyG、LP-PLA2水平。依据脑梗死面积将老年H型高血压伴ACI患者分为轻度梗死组(31例)、中度梗死组(42例)及重度梗死组(24例)3个亚组,比较不同梗死程度老年H型高血压伴ACI患者TyG、LP-PLA2水平。Pearson相关性分析TyG、LP-PLA2水平与脑梗死体积的关系。Logistic多因素回归分析确定老年H型高血压患者发生ACI的影响因素。
结果 研究组高血压2/3级占比、收缩压、舒张压、低密度脂蛋白胆固醇、同型半胱氨酸(homocysteine,Hcy)、TyG、LP-PLA2水平高于对照组(P<0.05)。中度梗死组和重度梗死组患者TyG(7.46±1.28、8.15±1.32)、LP-PLA2[(197.85±38.62) μg/L、(229.74±47.51) μg/L]水平高于轻度梗死组(6.83±1.15) μg/L、(175.68±34.59) μg/L;重度梗死组患者TyG、LP-PLA2水平高于中度梗死组(P<0.05)。老年H型高血压伴ACI患者TyG、LP-PLA2水平与脑梗死体积均呈正相关(r=0.547、0.623,P=0.026、0.018)。多因素分析结果显示,高血压(OR=2.912,95%CI:1.728~4.908)、Hcy(OR=2.959,95%CI:1.756~4.987)、TyG(OR=3.114,95%CI:1.848~5.248)、LP-PLA2(OR=3.364,95%CI:1.996~5.668)均为老年H型高血压患者发生ACI的相关影响因素(P<0.05)。
结论 老年H型高血压患者ACI患者TyG、LP-PLA2水平升高,TyG、LP-PLA2与老年H型高血压患者发生ACI密切相关。


关键词: 高血压, 脑梗死, 三酰甘油葡萄糖指数, 脂蛋白相关磷脂酶A2

Abstract: Objective To investigate the triglyceride glucose (TyG) index and lipoprotein-associated phospholipase A2 (LP-PLA2) levels and their clinical significance in elderly patients with H-type hypertension and acute cerebral infarction (ACI). 
Methods A total of 97 elderly patients with H-type hypertension complicated with ACI (research group) and 148 elderly patients with H-type hypertension (control group) were retrospectively analyzed. The clinical data, and TyG and LP-PLA2 levels were compared between the two groups. According to the area of cerebral infarction, the elderly patients with H-type hypertension and ACI were divided into three subgroups: mild infarction group (n=31), moderate infarction group (n=42) and severe infarction group (n=24). The levels of TyG and LP-PLA2 in elderly patients with H-type hypertension and different degrees of ACI were compared. Pearson correlation analysis was used to analyze the relationship between TyG, LP-PLA2 levels and cerebral infarction volume. Multivariate Logistic regression analysis was used to determine the influencing factors of ACI in elderly patients with H-type hypertension. 
Results The proportion of grade 2/3 hypertension, systolic blood pressure, diastolic blood pressure, low-density lipoprotein cholesterol, homocysteine (Hcy), TyG, and LP-PLA2 levels in the research group were higher than those in the control group (P<0.05). The levels of TyG (7.46±1.28, 8.15±1.32) and LP-PLA2 [(197.85±38.62) μg/L, (229.74±47.51) μg/L] in moderate infarction group and severe infarction group were higher than those in mild infarction group [(6.83±1.15) μg/L and (175.68±34.59) μg/L]. The levels of TyG and LP-PLA2 in the severe infarction group were higher than those in the moderate infarction group (P<0.05). TyG and LP-PLA2 levels were positively correlated with cerebral infarction volume in elderly patients with H-type hypertension and ACI (r=0.547 and 0.623, P=0.026 and 0.018). Multivariate analysis showed that hypertension (OR=2.912, 95%CI: 1.728-4.908), Hcy (OR=2.959, 95%CI: 1.756-4.987), TyG (OR=3.114, 95%CI: 1.848-5.248) and LP-PLA2 (OR=3.364, 95%CI: 1.996-5.668) were all related influencing factors for ACI in elderly patients with H-type hypertension (P<0.05). 
Conclusion TyG and LP-PLA2 levels are increased in elderly patients with H-type hypertension and ACI. TyG and LP-PLA2 are closely related to ACI in elderly patients with H-type hypertension. 


Key words: hypertension, brain infarction, triglyceride glucose index, lipoprotein-associated phospholipase A2