人血浆脂蛋白相关磷脂酶A2和脑梗死患者颈动脉斑块稳定性之间的关联

目的 探讨人血浆脂蛋白相关磷脂酶A₂(lipoprotein associated phospholipaseA₂ Lp-PLA₂)和脑梗死(cerebral infarction CI)患者颈动脉斑块稳定性之间的关联。方法 选取收入本院神经内科102例脑梗死患者; 根据颈动脉彩超检查分为不稳定型斑块组(54例)、稳定型斑块组(48例),并收入同时期的46名体检健康者作为对照组; 采用酶联免疫吸附试验(ELISA)检测3组的血浆脂蛋白相关磷脂酶A₂(Lp-PLA₂)水平; 检测血脂指标(TC、TG、LDL-C、HDL-C)水平; 对颈动脉斑块稳定性影响因素用Logistic回归分析。结果 脑梗死患者的Lp-PLA₂水平明显高于对照组,且不稳定型斑块组水平比稳定型斑块组要高(P<0.0001); 脑梗死患者的TC、LDL-C、TG水平高于对照组,且不稳定型斑块组水平比稳定型斑块组要高(P=0.0089),脑梗死患者的HDL-C水平低于对照组(P=0.0043)。Lp-PLA₂水平预测斑块稳定性的ROC曲线下面积为0.936(P<0.05),其临界值为56.75 μg/L时,灵敏度为76.5%,特异度为83.7%。结论 Lp-PLA₂是颈动脉斑块稳定性的独立危险因素,脑梗死患者Lp-PLA₂水平与颈动脉粥样硬化斑块稳定性有关,血浆Lp-PLA₂水平可预测斑块稳定性。

The relationship between human plasma lipoprotein associated phospholipase A2 and the stability of carotid plaques in cerebral infarction patients

ObjectiveTo investigate the relationship between human plasma lipoprotein associated phospholipase A2 and the stability of carotid plaques in cerebral infarction patients.Methods 102 cerebral infarction patients were chosen in our hospital. According to the carotid artery ultrasonography, these patients were divided into unstable plaque group(54 cases)and stable plaque group(48 cases)and 46 cases of healthy physical examination people(control group)were collected. Enzyme-linked immunosorbent assay(ELISA)were used to test plasma lipoprotein associated phospholipase A2(Lp-PLA2)levels in three groups. Blood fat levels(TC, TG, LDL, HDL-C-C)were compared among three groups, the influence factors on the stability of carotid plaques were analysis.Results Lp-PLA2 level of cerebral infarction patients was obviously higher than that of control group, and Lp-PLA2 level of unstable plaque group was higher than that of stable plaque group(P<0.0001); TC, LDL-C, TG levels of Cerebral infarction group were higher than those of control group, and TC, LDL-C, TG levels of unstable plaque group were higher than those of stable plaque group(P=0.0089); HDL-C level of cerebral infarction group was lower than that of control group(P=0.0043).The area under the ROC curve of Lp-PLA2 which predicted plaque stability was 0.936(P<0.05), the diagnostic value of 56.75 μg/L, the sensitivity was 76.5%, 83.7%.Conclusion The Lp-PLA2 was an independent risk factor on the stability of carotid plaques. Lp-PLA2 level of cerebral infarction patients was associated with stability of carotid plaques. Lp-PLA2 level could predict plaque stability.