血清脂蛋白相关磷脂酶A2水平对颈动脉粥样硬化斑块及其稳定性预测价值的研究

目的 研究血清脂蛋白相关磷脂酶A2（1ipoprotein-associated phospholipase A2，Lp-PLA2）水平对颈动 脉粥样硬化斑块及其稳定性的预测价值。 方法 本研究患者来源于无症状性多血管床狭窄的社区研究 (A s y m p t o m at i c P o l y v a s c u l a r Abnormalities Community，APAC)。检测入组患者血清Lp-PLA2水平，通过超声评估颈动脉粥样硬化斑块 特点。按照血清Lp-PLA2水平的四分位数，将受试者分为4组，用Logistic回归模型分析血清Lp-PLA2水 平与颈动脉粥样硬化斑块及斑块稳定性的关系。 结果 高Lp-PLA2水平（＞159.1 ng/mL）是颈动脉不稳定斑块发生的预测因素（OR 2.8，95%CI 2.0～3.8，P <0.0001），在校正危险因素后，这种趋势没有发生变化（OR 1.7，95%CI 1.2～2.5，P＝ 0.0067），在＜60岁受试者中，该差异仍然存在（OR 1.7，95%CI 1.1～2.7，P =0.0142），但在≥60岁受试 者中，其预测价值未达到统计学意义。 结论 较高血清Lp-PLA2水平是颈动脉不稳定粥样硬化斑块发生的预测因素，尤其在＜60岁患者中。

Association between Serum Lipoprotein-associated Phospholipase A2 Level and Carotid Plaque Development and Vulnerability: a Cross-sectional Study

Objective To investigate the association of serum total 1ipoprotein-associated phospholipase A2
(Lp-PLA2) level with the vulnerability of atherosclerotic carotid plaques.
Methods Data of this cohort study were from Asymptomatic Polyvascular Abnormalities
Community (APAC) study, which was a cross-sectional study. The data of serum Lp-PLA2 level
and ultrasonographic assessment of carotid plaques were extracted and analyzed. The participants
were divided into 4 groups based on the quartile of serum total Lp-PLA2 level. The multivariate
logistic regression analysis was used to analyze the correlation between the serum total Lp-PLA2
level and carotid plaque development and vulnerability.
Results A high Lp-PLA2 level (>159.1 ng/mL) was associated with carotid plaque vulnerability
amongst the adults (OR 2.8, 95%CI 2.0-3.8, P <0.0001). After adjusting for the relevant risk factors,
the tendency still existed (OR 1.7, 95%CI 1.2-2.5, P =0.0067). For subjects aged <60 years old, the
correlation between the two variates still existed (OR 1.7, 95%CI 1.1-2.7, P =0.0142), while for
subjects aged ≥60 years old, the difference of serum Lp-PLA2 level among the 4 groups had no
statistical significance
Conclusions An elevated serum Lp-PLA2 level was associated with carotid plaque vulnerability in
adults, especially ones aged <60 years.