血清脂蛋白相关磷脂酶A2、尿酸、胱抑素C与颈动脉易损斑块的相关性研究

目的 探讨颈动脉易损斑块与脂蛋白相关磷脂酶A₂（lipoprotein-associated phospholipase A₂,Lp-PLA₂）、尿酸（uric acid, UA）、胱抑素C（cystatin C,Cys C）的关系。方法 选取延安大学附属医院神经内科2019年4月至2021年4月收治的212例住院患者,根据颈动脉内中膜厚度（intima-media thickness, IMT）分为对照组、稳定斑块组、易损斑块组。对比3组血清Lp-PLA2、UA、Cys C表达水平,采用Logistic回归法分析Lp-PLA₂、UA、Cys C与颈动脉易损斑块的关系。结果 颈动脉斑块组Lp-PLA₂、UA水平高于对照组（P<0.05）;易损斑块组血清Lp-PLA₂、UA、Cys C水平均高于稳定斑块组,差异有统计学意义（P<0.05）;Logistic回归分析结果显示,血清Lp-PLA₂、UA、Cys C水平为易损斑块的独立危险因素（P<0.05）。结论 血清Lp-PLA₂、UA、Cys C水平与颈动脉斑块稳定性密切相关,是颈动脉易损斑块的独立危险因素,三者联合检测可作为预测颈动脉斑块稳定性的指标。

Study on the correlation between serum lipoprotein-associated phospholipase A2, uric acid,cystatin C and carotid vulnerable plaque

Objective To investigate the relationship between carotid vulnerable plaque and serum lipoprotein-associated phospholipase A₂ （Lp-PLA₂）, uric acid （UA） and cystatin C （Cys C）.Methods 212 patients treated in department of neurology, Affiliated Hospital of Yan'an University from April 2019 to April 2021 were divided into control group, stable plaque group, and vulnerable plaque group according to the carotid intima-media thickness （IMT）. The expression levels of Lp-PLA₂, UA and Cys C in serum of the three groups were compared, and the relationship between Lp-PLA₂, UA, Cys C and vulnerable carotid plaque was analyzed by logistic regression.Results The levels of Lp-PLA2 and UA in carotid plaque group were higher than those in control group （P<0.05）; the levels of serum Lp-PLA₂, UA and Cys C in vulnerable plaque group were higher than those in stable plaque group （P<0.05）; logistic regression analysis showed that serum Lp PLA₂, UA and Cys C levels were independent risk factors for vulnerable plaque （P<0.05）.Conclusion Serum Lp-PLA₂, UA and Cys C levels are closely related to carotid plaque stability, and these three indexes are independent risk factors for carotid plaque. The combined detection of these three indexes can be used as an indicator to predict the stability of carotid plaque.