Abstract: Objective To investigate the relationship of peripheral blood lipoprotein-related phospholipase A2 (LP-PLA2) and central nervous system specific protein (S100-β)in peripheral blood with the severity and prognosis of elderly patients with H-type hypertension（HHT） and acute cerebral infarction (ACI). 
Methods Ninety-six elderly patients with HHT and ACI and 85 elderly patients with HHT treated in Geriatric Hospital of Changzhou City, Jiangsu Province, as well as 80 healthy patients who underwent physical examination in the hospital during the same period were selected as HHT + ACI group, HHT group, and healthy group, respectively. The clinical data and peripheral blood LP-PLA2 and S100-β levels of the three groups were compared. According to the area of cerebral infarction, elderly patients with HHT and ACI were divided into three subgroups: mild infarction group, moderate infarction group, and severe infarction group. According to the prognosis, the elderly patients with HHT and ACI were divided into poor prognosis group and good prognosis group. The peripheral blood LP-PLA2 and S100-β levels of elderly patients with HHT and ACI with different infarction degrees were compared. The clinical data in good prognosis group and poor prognosis group were compared. Multivariate Logistic regression analysis was used to analyze the risk factors affecting the prognosis of elderly patients with HHT and ACI. The receiver operating characteristic (ROC) curve was drawn to analyze the value of peripheral blood LP-PLA2, S100-β and the combination of the two in predicting the poor prognosis of elderly patients with HHT and ACI. 
Results The systolic blood pressure, diastolic blood pressure, homocysteine (Hcy), LP-PLA2 and S100-β levels of the HHT + ACI group and HHT group were higher than those of the healthy group (P＜0.05). LP-PLA2 and S100-β in the HHT + ACI group and HHT group were higher than those in the healthy group (P＜0.05). LP-PLA2 and S100-β were higher in HHT + ACI group than in HHT group (P＜0.05). The levels of peripheral blood LP-PLA2 and S100-β in the severe infarction group were higher than those in the mild and moderate infarction groups (P＜0.05). The peripheral blood LP-PLA2 and S100-β in the moderate infarction group were higher than those in the mild infarction group (P＜0.05). The incidence of poor prognosis in elderly patients with HHT and ACI was 33.33%. The proportion of hypertension grade Ⅲ, glycosylated hemoglobin (HbA1c), peripheral blood LP-PLA2 and S100-β levels in the poor prognosis group were higher than those in the good prognosis group (P＜0.05), while the uric acid (UA) level in the poor prognosis group was lower than the good prognosis group (P＜0.05). Logistic regression analysis showed that UA, peripheral blood LP-PLA2 and S100-β levels were all risk factors affecting the prognosis of elderly patients with HHT and ACI (OR=2.861, 3.370, 3.483, P＜0.05). ROC analysis showed that the area under the ROC curve (AUC) of combined detection of peripheral blood LP-PLA2 and S100-β in predicting poor prognosis of elderly patients with HHT and ACI was 0.851, which was higher than that of peripheral blood LP-PLA2 and S100-β alone (P＜0.05). 
Conclusion Peripheral blood LP-PLA2 and S100-β are related to the severity and prognosis of elderly patients with HHT and ACI. In addition, peripheral blood LP-PLA2 and S100-β have higher efficiency in predicting the prognosis of elderly patients with HHT and ACI, which can be used as important reference indexes for evaluating the prognosis of these patients.

Key words: cerebral infarction, acute, H-type hypertension, elderly