脂蛋白相关磷脂酶 A2与颈动脉粥样硬化性脑梗死的相关性研究

Study on the Relationship Between Lipoprotein Associated Phospholipase A2 and Carotid Ather-osclerotic Cerebral Infarction

[目的]探讨脑梗死患者血清脂蛋白相关磷脂酶A2（Lp-PLA2）及同型半胱氨酸（HCY）水平与颈动脉粥样硬化的相关性。[方法]选择颈动脉粥样硬化性脑梗死患者（脑梗死组，76例）和健康体检者（对照组，60例）为研究对象，应用颈动脉彩色多普勒超声检查颈动脉内膜中层厚度（IM T ），检测所有研究对象血清Lp-PLA2、HCY水平，并行相关分析。[结果]①脑梗死组的Lp-PLA2、HCY、IM T均显著高于对照组，且两组相比较差异均有显著性（ P ＜0．01）。②脑梗死组易损斑块的比例（39．2％）明显高于对照组（14．3％），且两组相比较差异有显著性（ P＜0．05）。③易损斑块组血清Lp-PLA2、IM T明显高于稳定斑块组，且两者相比较差异有显著性（ P ＜0．01）。④稳定斑块组血清Lp-PLA2、HCY和IM T均高于无斑块组，且两组相比较差异有显著性（ P ＜0．05）。⑤血清Lp-PLA2辅助识别易损斑块特异性高于 HCY。[结论]与 HCY比较，血清Lp-PLA2与颈动脉粥样硬化易损斑块的相关性更好；血清Lp-PLA2能反映斑块的不稳定，可作为临床预测脑梗死的血清学指标。

[Objective] To explore the relationship of serum lipoprotein associated phospholipase A 2（Lp-PLA2 ） and homocysteine（HCY） with carotid artery atherosclerosis .[Methods]The patients with carotid ath-erosclerotic cerebral infarction（cerebral infarction group ,n =76） and healthy controls（control group ,n =60） were enrolled in the study .Carotid color doppler ultrasonography was used to measure intimal-medial thick-ness（IMT） of internal carotid artery .Serum levels of Lp-PLA2 and HCY in all subjects were examined for cor-relation analysis .[Results] The levels of Lp-PLA2 ,HCY and IMT in cerebral infarction group were signifi-cantly higher than those in control group （ P 〈 0 .01） .The ratio of vulnerable plaque in cerebral infarction group（39 .2% ） was obviously higher than that in control group（14 .3% ） ,and there was significant difference between two groups（ P〈0 .05） .Serum levels of Lp-PLA2 and IMT in vulnerable plaque group were obviously higher than those in stable plaque group ,and there we significant difference between two groups （ P〈0 .01） . Serum levels of Lp-PLA2 ,HCY and IMT in stable plaque group were higher than those in no plaque group , and there was significant difference（ P〈0 .05） .The specificity of serum Lp-PLA2 for discriminating vulnera-ble plaque of carotid atherosclerosis was stronger than that of HCY .[Conclusion]Compared with HCY ,serum Lp-PLA2 has better correlation with vulnerable plaque of carotid atherosclerosis .Serum Lp-PLA2 can reflect the unstability of plaque and be used as a serological biomarker to predict cerebral infarction .