血清ox-LDL、Lp-PLA2水平与缺血性脑卒中患者动脉粥样硬化及神经功能缺损的相关性研究

目的 探讨缺血性脑卒中患者血清中氧化低密度脂蛋白(ox-LDL)和脂蛋白相关磷脂酶A2(Lp-PLA2)水平与颈动脉粥样硬化及神经功能缺损的相关性。方法 选取2015年7月～2016年7月本院神经内科收治的急性脑梗死患者135例(ACI组)和同期本院体检中心健康人群150例(对照组),均对所有入选者血清中的ox-LDL、Lp-PLA2水平进行检测,比较ACI组和对照组的血清ox-LDL、Lp-PLA2及其他血脂指标水平; 行颈动脉超声检查,对无斑块组、稳定斑块组和不稳定斑块组患者的ox-LDL、Lp-PLA2水平进行比较; 按美国国立卫生研究院卒中量表(NIHSS)评分,对轻型、中型、重型患者的ox-LDL、Lp-PLA2水平进行比较。结果 ACI组的血清ox-LDL、Lp-PLA2水平均高于对照组(P<0.01); 稳定斑块组、不稳定斑块组血清ox-LDL、Lp-PLA2水平显著高于无斑块组(P<0.05); 不稳定斑块组血清ox-LDL、Lp-PLA2 水平显著高于稳定斑块组(P<0.05); NIHSS评分中型组、重型组血清ox-LDL、Lp-PLA2水平均显著高于轻型组(P<0.05),重型组血清ox-LDL、Lp-PLA2水平显著高于中型组(P<0.05)。结论 缺血性脑卒中患者血清ox-LDL、Lp-PLA2水平较正常者显著上升,其在一定程度上反映患者颈动脉粥样硬化的程度及神经功能缺损的程度,ox-LDL、Lp-PLA2 可作为急性缺血性脑血管病的血清标记物,在评估急性缺血性脑血管病的病情及预后方面有一定的临床意义。

Association of serum ox-LDL and Lp-PLA2 levels with atherosclerosis and neurological deficits in patients with ischemic stroke

ObjectiveTo investigate the correlation between in the low density lipoprotein(ox-LDL),lipoprotein associated phospholipase A2(Lp-PLA2)and carotid atherosclerosis, the neurological deficits in patients with acute ischemic stroke.Methods 135 patients(ACI group)with acute cerebral infarction were treated in neurology department and 150 cases(control group)of healthy population at the center of physical examination were collected from July 2015 to July 2016, the ox-LDL and the Lp-PLA2 and other blood lipids were tested and compared between the ACI group and control group.In the mean time, all selected cases were divided into the nonplque group,the stable plaques group and unstable plaques group according to carotid artery ultrasonography, the ox-LDL and the Lp-PLA2 and other blood lipids were tested and compared among the nonplque group,the stable plaques group and unstable plaques group. all selected cases were divided into the moderate group,the minor group and severe group according to the NIHSS, the ox-LDL and the Lp-PLA2 and other blood lipids were tested and compared among the moderate group,the minor group and severe group.Results The serum ox-LDL and Lp-PLA2 levels in ACI group were higher than those in the control group(P<0.01); the serum ox-LDL, Lp-PLA2 levels were significantly higher in the nonplque group,the stable plaques group than those in theunstable plaques group(P<0.05), the serum ox-LDL, Lp-PLA2 levels were significantly higher in the unstable plaques group than those in the stable plaque group(P<0.05), the serum ox-LDL and Lp-PLA2 levels were significantly higher in the moderate group, severe group than that in the minor group(P<0.05), the serum ox-LDL and Lp-PLA2 levels in the severe group were significantly higher than that in the moderate group(P<0.05).Conclusion In patients with ischemic stroke, the serum ox-LDL and Lp-PLA2 levels were considerably higher, and it reflected the degree of carotid atherosclerosis and the degree of neurological deficit. the serum ox-LDL and Lp-PLA2 levels could be acted as the serum markers of acute ischemic cerebrovascular disease, and it had the clinical significance in assessing the condition and prognosis of acute ischemic cerebrovascular disease.