颈动脉超声造影与人血浆脂蛋白相关磷脂酶A_2在动脉粥样硬化性脑梗死预后判定中的应用

目的探讨颈动脉彩色超声造影和人血浆蛋白相关磷脂酶A2(Lp-PLA2)在动脉粥样硬化血栓性脑梗死(ATCI)诊断和预后判定中的应用价值。方法利用彩色超声造影技术对30例ATCI患者和30例TIA患者的颈动脉斑块进行评估,采用增强免疫比浊法测定Lp-PLA_2含量,并与30例健康者进行比较。结果 (1)ATCI组和TIA组患者的颈动脉稳定粥样斑块发生率和颈动脉内-中膜厚度比较均无统计学意义(P0.05),但均高于正常对照组(P0.05);3组不稳定斑块发生率和Lp-PLA_2水平比较均有统计学意义(P0.05)。(2)ATCI组中随着患者NIHSS评分的增加,颈动脉不稳定斑块的发生率和Lp-PLA_2水平均随之升高(P0.05)。结论颈动脉斑块的性质和Lp-PLA_2与ATCI有一定的相关性;Lp-PLA_2能较准确地反映颈动脉斑块的稳定性,两种检查相联合可在一定程度上预测ATCI患者的预后。

Application of contrast-enhanced ultrasound in the carotid arteries and level of plasma lipoprotein-associated phospholipase A2 in the prognosis of atherosclerotic cerebral infarction

Objective To determine the significance of the carotid contrast-enhanced ultrasound and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with atherosclerotic cerebral infarction (ATCI).Methods Totally 30 patients with ATCI,30 patients with transient ischemic attack (TIA) and 30 healthy controls were collected.Carotid contrast-enhanced ultrasound was used to evaluate carotid plaque and the plasma level of Lp-PLA2 in each group was detected by particle-enhanced turbidimetric immunoassay.Results The incidences of stable plaque and intima-media thickness in carotid arteries hadn't difference between the patients with ATCI and these with TIA (P>0.05),which were higher than those in the healthy controls (P<0.05).Incidence of unstable carotid plaque and plasma levels of Lp-PLA2 had statistical significance among the three groups (P<0.05).As the NIHSS score increased,the incidence of unstable carotid plaque and the plasma level of Lp-PLA2 were also increased in the ATCI group (P<0.05).Conclusions Nature of plaques in carotid arteries and plasma Lp-PLA2 level are associated with ATCI and the Lp-PLA2 level can accurately reflect the stability of carotid plaques.The combined utilization of the carotid contrast-enhanced ultrasound and plasma Lp-PLA2 can be used to estimate the prognosis of ATCI.