血清脂蛋白相关磷脂酶A2及C反应蛋白与颈动脉粥样硬化斑块易损性的关系

目的探讨脂蛋白相关磷脂酶A2（Lipoprotein—associated phospholipase A2，Lp—PLA2）、C反应蛋白（C—reactive protein，CRP）与急性前循环脑梗死患者颈动脉粥样硬化斑块易损性的关系。方法100例急性前循环脑梗死患者（脑梗死组）和40例体检健康者（对照组），检测2组血清Lp—PLA2、CRP水平；应用彩色多普勒超声评估脑梗死患者颈动脉粥样硬化程度，并对进行神经功能缺损评分。结果脑梗死组血清Lp—PLA2、CRP水平高于对照组（P〈0．01）；随着脑梗死患者颈动脉粥样硬化程度及病情程度加重，易损斑块组、稳定斑块组、内膜增厚组、内膜正常组，以及重度组、中度组、轻度组血清Lp—PLA2、CRP水平依次降低，组间差异均有统计学意义（P〈0．05）。结论急性脑梗死患者血清Lp—PLA2、CRP水平可反映颈动脉粥样硬化斑块性质和稳定性，可作为脑梗死病情严重程度的敏感指标。

Relationship of serum lipoprotein-associated phospholipase A2 and C-reactive protein with carotid atherosclerotic plaques vulnerability

Objective To investigate the relationship of lipoprotein-associated phospholipase A2 （Lp-PLA2） and C- reactive protein （CRP） with carotid atherosclerosis plaque vulnerability in patients with acute anterior circulation cerebral infarction. Methods The serum Lp-PLA2 and CRP levels in 100 patients with acute anterior circulation cerebral infarction （infarction group） and 40 healthy volunteers （control group） were detected by immune scattering turbidimetry, Lp-PLA2 kit and color Doppler ultrasound, and carotid atherosclerosis and the neurological function were evaluated in infarction group. Results The serum Lp-PLA2 and CRP levels were significantly higher in infarction group than those in control group （P〈0.01）, and increased along with the severity of carotid atherosclerosis. The serum Lp-PLA2 and CRP levels were highest in vulnerable plaque group, followed by stable plaque group, intima thickening group and normal endometrium group in turn （P〈0. 05）, and were highest in severe group, followed by moderate group and light group （P〈0.05）. Conclusions The serum Lp-PLA2 and CRP levels can reflect the nature and the stability of carotid atherosclerotic plaques in patients with acute cerebral infarction, which can be used as the sensitive indexes for evaluating the severity of cerebral infarction.