缺血性脑卒中患者脑动脉硬化与分泌型磷脂酶A2水平相关性研究

目的探讨分泌型磷脂酶A2（sPLA2）在脑动脉硬化中的变化情况并分析其相关性，评价其在缺血性卒中诊疗方面的价值。方法选取150例患者作为研究对象，采用头颅MRA评价其颅内血管情况，根据MRA结果分为：头颅MRA正常组38例、三级分支减少组37例、狭窄组38例、闭塞组37例，比较每组患者的sPLA2水平。同时伴有头颅MRA异常与颈动脉硬化患者82例，其余仅有头颅MRA异常（颈动脉彩超正常）30例患者、仅有颈动脉硬化患者（MRA正常）38例患者作为对照组，比较三组sPLA2水平。结果闭塞组血清sPIA2水平升高最明显，与狭窄组、三级分支减少组和MRA正常组比较均有统计学意义（t=5．73、11．35、8．27，均P〈0．05），狭窄组、三级分支减少组和MRA正常组血清sPLA2水平依次递减，各组间差异均有统计学意义（t=5．81、6．37、29．54，均P〈0．05）。同时伴有头颅MRA异常与颈动脉硬化患者82例血清sPLA2水平显著高于对照组（t=35．46、21．97，均P〈0．05）。结论sPLA2与脑动脉硬化具有相关性，动脉硬化程度越高，其水平越高，sPLA2可以作为缺血性脑卒中的辅助诊断方法。

The relationship between secretory phospholipase A2 and cerebral arteriosclerosis in ischemic stroke patients

Objective To observe the changes of secretory phospholipase A2 （sPLA2） in cerebral arterio- sclerosis and analyze its relationship with cerebral arteriosclerosis,in order to evaluate the diagnostic value of sPLA2 in ischemic stroke. Methods 150 patients were selected in the present study. Brain MRA was used to evaluate the intracranial vessels. According to the MRA results,150 patients were divided into：skull MRA normal group of 38 ca- ses, tertiary branches reduction group of 37 cases, stenosis group of 38 cases, occlusion group of 37 cases, sPLA2 level in the three groups was compared. 82 patients with carotid atherosclerosis accompanied by brain MRA abnormalities, the rest 30 patients with just brain MRA abnormalities （ carotid ultrasonography normal） and 38 patients only with ca- rotid atherosclerosis （ MRA normal） were selected as control group. The sPLA2 level was compared among three groups. Results The serum sPLA2 level of occlusion group was significantly higher than that of stenosis group,tertia- ry branches reduction group and MRA normal group, the differences were statistically significant （ t = 5.73,11.35, 8. 27, all P 〈 0.05 ）. The serum sPLA2 level of stenosis group, tertiary branches reduction group and MRA normal group was gradually decreased,, the differences among the three groups were statistically significant （t = 5.81,6.37, 29.54, all P 〈 0.05）. The serum sPLA2 level in 82 patients with carotid atherosclerosis accompanied by brain MRA abnormalities was significantly higher than the control groups （ t = 35.46,21.97, P 〈 0.05 ）. Conclusion sPLA2 is correlated with cerebral arteriosclerosis, the higher degree of atherosclerosis,the higher level of sPLA2, sPLA2 can be used to help the diagnosis of ischemic stroke.