作者：季燕，朱锋，宋建华

单位：

226000江苏省南通市第三人民医院 南通大学附属南通第三医院神经内科

Units：

Department of Neurology, the Third People's Hospital of Nantong/Nantong Third Hospital Affiliated to Nantong University, Nantong 226000, China

关键词：

高血压；急性脑梗死；高迁移率族蛋白B1；脂蛋白相关磷脂酶A2；中性粒细胞与淋巴细胞比值

Keywords：

Hypertension; Acute cerebral infarction; High mobility group protein B1; Lipoprotein-associated phospholipase A2; Neutrophil to lymphocyte ratio

CLC：

R 544.1 R 743.33

DOI：

10.12114/j.issn.1008-5971.2023.00.300

Funds：

江苏省自然科学基金青年基金项目（BK20220447）

摘要：

目的　探讨高迁移率族蛋白B1（HMGB1）、脂蛋白相关磷脂酶A2（Lp-PLA2）、中性粒细胞与淋 巴细胞比值（NLR）诊断高血压患者合并急性脑梗死（ACI）的价值及其与病情严重程度的关系。方法　选取2020 年2月至2023年2月南通市第三人民医院收治的高血压患者 157例为研究对象，根据患者是否合并 ACI将其分为合并组 （n=102）和未合并组（ n=55）。收集所有患者的性别、年龄、 BMI、吸烟史、饮酒史、合并糖尿病情况、收缩压、 舒张压、总胆固醇、尿素氮，同时收集合并组患者的ACI家族史、梗死部位、梗死体积、梗死类型。检测所有患者 HMGB1 、Lp-PLA2、NLR。合并组患者根据病情严重程度分为轻度亚组（ n=41）、中度亚组（n=32）、重度亚组 （ n=29）。比较合并组和未合并组 HMGB1、Lp-PLA2、NLR，采用ROC曲线分析HMGB1、Lp-PLA2、NLR诊断高血 压患者合并ACI的价值，比较轻度亚组、中度亚组、重度亚组一般资料、HMGB1、Lp-PLA2、NLR。结果　合并组 HMGB1、Lp-PLA2、NLR高于未合并组（P＜0.05）。ROC曲线分析结果显示，HMGB1、Lp-PLA2、NLR诊断高血压 患者合并ACI的曲线下面积分别为0.798、0.892、0.912，最佳截断值分别为6.69 μg/L、156.02 μg/L、3.11，灵敏度 分别为0.657、0.853、0.931，特异度分别为0.818、0.764、0.891。中度亚组HMGB1、Lp-PLA2、NLR高于轻度亚组， 重度亚组HMGB1、Lp-PLA2、NLR高于轻度亚组和中度亚组（P＜0.05）。结论　高血压合并ACI患者HMGB1、Lp PLA2、NLR明显升高，HMGB1、Lp-PLA2、NLR对高血压患者合并ACI具有一定诊断价值，且与患者病情严重程度 相关。

Abstract：

Objective To investigate the value of high mobility group protein B1 (HMGB1) , lipoprotein-associated phospholipase A2 (Lp-PLA2) , and neutrophil to lymphocyte ratio (NLR) in the diagnosis of hypertension patients complicated with acute cerebral infarction (ACI) and their relationship with the severity of the disease. Methods A total of 157 hypertensive patients admitted to the Third People's Hospital of Nantong from February 2020 to February 2023 were selected as the research subjects. The patients were divided into the combined group (n=102) and the non-combined group (n=55) according to whether they had ACI. Gender, age, BMI, smoking history, drinking history, diabetes, systolic blood pressure, diastolic blood pressure, total cholesterol, and urea nitrogen of all patients were collected. Meanwhile, family history of ACI, infarct location, infarct volume, and infarction type of patients in the combined group were collected. The levels of HMGB1, Lp-PLA2 and NLR of all patients were detected. Patients in the combined group were divided into mild subgroup (n=41) , moderate subgroup (n=32) and severe subgroup (n=29) according to the severity of the disease. HMGB1, Lp-PLA2 and NLR were compared between combined group and non-combined group. The ROC curve was used to explore the value of the HMGB1, Lp-PLA2 and NLR in diagnosing ACI in hypertension patients. The general data, HMGB1, Lp-PLA2, NLR were compared in mild subgroup, moderate subgroup and severe subgroup. Results HMGB1, Lp-PLA2 and NLR in the combined group were higher than those in the non-combined group (P < 0.05) . ROC curve analysis showed that the AUC of the HMGB1, Lp-PLA2, NLR in diagnosing ACI in hypertension patients was 0.798, 0.892, 0.912, and the best cut-off values were 6.69 μg/L, 156.02 μg/L, 3.11, the sensitivities were 0.657, 0.853, 0.931, and specificities were 0.818, 0.764, 0.891, respectively. HMGB1, Lp-PLA2 and NLR in moderate subgroup were higher than those in mild subgroup, and HMGB1, Lp-PLA2 and NLR in severe subgroup were higher than those in mild subgroup and moderate subgroup (P < 0.05) . Conclusion HMGB1, Lp-PLA2 and NLR are significantly elevated in hypertension patients complicated with ACI, and HMGB1, Lp-PLA2 and NLR have certain value in the diagnosis of ACI in hypertension patients, which are related to the severity of the patients' disease.

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