脂蛋白相关磷脂酶A2与颈动脉粥样硬化和颈内动脉短暂性脑缺血发作的关系

目的 研究脂蛋白相关磷脂酶A2(Lp-PLA2)和颈动脉超声对短暂性脑缺血发作(TIA)的诊断价值.方法 以90例急性期颈内动脉系统TIA患者(TIA组)和55例健康体检者(正常对照组)为研究对象,应用颈动脉超声检测颈动脉内膜情况,应用酶联免疫吸附测定法(ELISA)检测血清Lp-PLA2,并进行统计学比较.结果 TIA组颈动脉粥样硬化斑块检出率显著高于正常对照组[分别为78.9%(71/90)与29.1%(16/55),x2=35.27,P<0.01].正常对照组颈动脉粥样硬化斑块总数35块,其中不稳定斑块6块,稳定斑块29块;TIA组颈动脉粥样硬化斑块总数134块,其中不稳定斑块103块,稳定斑块3l块,TIA组不稳定斑块构成比显著高于正常对照组(x2=43.22,P<0.01).TIA组男性和女性血清Lp-PLA2,分别为(19.08±7.92)、(15.15±4.91)mol/(min·ml),正常对照组男性和女性血清Lp-PLA2分别为(13.86±3.15)、(11.18±2.96)mol/(m/n·ml),TIA组均显著高于相应正常对照组(t值分别为3.8598、2.9260,P均<0.01),且TIA组和正常对照组血清Lp-PLA2男性均显著高于女性(t值分别为2.3850、2.9143,P均<0.05).TIA组不稳定斑块组血清Lp-PLA2为(20.16±6.76)mot/(min·ml),稳定斑块组血清Lp-PLA2为(16.09±4.15)mot/(min·ml),2组比较差异有统计学意义(t=2.5578,P<0.05).结论 血清Lp-PLA2是颈动脉斑块的一种危险因素,联合Lp-PLA2检测和颈动脉超声检查可以预警TIA的发生.

Abstract：

Objective To evaluate the diagnostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) and carotid artery ultra sound for transient ischemic attack (TIA) . Methods Ninety patients with TIA of internal carotid artery system in the acute phase and 55 normal control subjects were recruited. Their carotid intima-media thicknesses were assessed by carotid ultrasonography. Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbentassay(ELISA) ,and all the data were compared between the two group. Results The detection rate of carotid atherosclerotic plaque in the TIA group was significantly higher than that in the control group f 78. 9% (71/90) vs. 29. 1% (16/55), x2 = 35. 27, P < 0.01] . There were 35 carotid atherosclerotic plaque in the control group,of which 6 were unstable plaques and 29 were stable plaques. There were 134 carotid atherosclerotic plaque in the TIA group,of which 103 were unstable plaques and 31 were stable plaques, the constituent ratio of unstable plaque in the TIA group was significantly higher than that in the control group (x2 =43. 22 ,P < 0. 01). The levels of serum Lp-PLA2 in male and female patients in TIA group were ([19. 08 ±7. 92] mol/(min · ml) and [15. 15 ±4. 91] mol/(min · ml),which were significantly higher than those in male and female in the control group ([13. 86 ± 3. 15] mol/(min · ml) and [11. 18 ± 2. 96] mol/ (min · ml) (t = 3. 8598 and 2. 9260, respectively, Ps < 0. 01). Furthermore, the levels of serum Lp-PLA2 of males in the TIA group and control group were significantly higher than that of females in the TIA group and control group(t=2. 3850 and 2. 9143, respectively, Ps < 0.05). The level of serum Lp-PLA2 in unstable plaque patients in the TIA group was (20.16 ± 6. 76) mol/ (min · ml) , which was significantly higher than that in stable plaque patients in the TIA group was (16. 09 ±4. 15)mol/(min · ml) ,the difference was statistically significant (t = 2. 5578, P < 0. 05). Conclusion Serum Lp-PLA2 is a risk factor of carotid atherosclerotic plaque, the combination of Lp-PLA2 and carotid ultrosonography can be used and alert indicator of TIA.

Association between Lp-PLA2 and carotid atherosclerosis and transient ischemic attack of internal carotid artery system

Objective To evaluate the diagnostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) and carotid artery ultra sound for transient ischemic attack (TIA) . Methods Ninety patients with TIA of internal carotid artery system in the acute phase and 55 normal control subjects were recruited. Their carotid intima-media thicknesses were assessed by carotid ultrasonography. Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbentassay(ELISA) ,and all the data were compared between the two group. Results The detection rate of carotid atherosclerotic plaque in the TIA group was significantly higher than that in the control group f 78. 9% (71/90) vs. 29. 1% (16/55), x2 = 35. 27, P < 0.01] . There were 35 carotid atherosclerotic plaque in the control group,of which 6 were unstable plaques and 29 were stable plaques. There were 134 carotid atherosclerotic plaque in the TIA group,of which 103 were unstable plaques and 31 were stable plaques, the constituent ratio of unstable plaque in the TIA group was significantly higher than that in the control group (x2 =43. 22 ,P < 0. 01). The levels of serum Lp-PLA2 in male and female patients in TIA group were ([19. 08 ±7. 92] mol/(min · ml) and [15. 15 ±4. 91] mol/(min · ml),which were significantly higher than those in male and female in the control group ([13. 86 ± 3. 15] mol/(min · ml) and [11. 18 ± 2. 96] mol/ (min · ml) (t = 3. 8598 and 2. 9260, respectively, Ps < 0. 01). Furthermore, the levels of serum Lp-PLA2 of males in the TIA group and control group were significantly higher than that of females in the TIA group and control group(t=2. 3850 and 2. 9143, respectively, Ps < 0.05). The level of serum Lp-PLA2 in unstable plaque patients in the TIA group was (20.16 ± 6. 76) mol/ (min · ml) , which was significantly higher than that in stable plaque patients in the TIA group was (16. 09 ±4. 15)mol/(min · ml) ,the difference was statistically significant (t = 2. 5578, P < 0. 05). Conclusion Serum Lp-PLA2 is a risk factor of carotid atherosclerotic plaque, the combination of Lp-PLA2 and carotid ultrosonography can be used and alert indicator of TIA.