脑梗死患者血清髓过氧化物酶和妊娠相关血浆蛋白A与颈动脉易损斑块的相关性

Research on the Relationship Between Serum Myeloperoxidase,Pregnancy-Associated Plasma Protein-A and Stability of Carotid Plaques in Patients with Cerebral Infarction

目的探讨脑梗死患者血清髓过氧化物酶(MPO)和妊娠相关血浆蛋白A(PAPP-A)水平与颈动脉易损斑块的相关性。方法 52例存在颈动脉斑块的脑梗死患者行颈动脉斑块高分辨率MRI检查,根据斑块影像学特征分组。应用酶联免疫吸附法测定血清MPO和PAPP-A水平。结果不稳定性斑块组和不稳定性斑块破裂组血清MPO和PAPP-A水平高于稳定性斑块组(P<0.05或P<0.01)。不稳定性斑块未破裂组血清MPO水平高于稳定性斑块组(P<0.05),不稳定性斑块破裂组PAPP-A水平高于不稳定性斑块未破裂组(P<0.01)。不稳定性斑块未破裂组与不稳定性斑块破裂组之间血清MPO水平差异无显著性,不稳定性斑块未破裂组与稳定性斑块组之间血清PAPP-A水平差异无显著性。血清MPO和PAPP-A水平与斑块易损程度呈正相关关系(P<0.01)。结论血清MPO和PAPP-A水平可以反映颈动脉粥样硬化斑块的稳定性及破裂性。

Aim To study the relationship between serum myeloperoxidase（MPO）,pregnancy-associated plasma protein-A（PAPP-A） and stability of carotid plaques in patients with cerebral infarction.Methods The study included 52 patients with cerebral infarction and with carotid plaques confirmed by high resolution MRI.Patients were classified according to the characteristic findings of plaques in MRI.Serum levels of MPO and PAPP-A were determined by ELISA.Results Serum levels of MPO and PAPP-A in patients of unstable plaques group and rupture plaques group were significantly enhanced compared to individuals of stable plaques group（P0.05 or P0.01）.Serum levels of MPO in patients of unrupture plaques group were significantly enhanced compared to individuals of stable plaques group（P0.05）.Serum levels of PAPP-A in patients of rupture plaques group were significantly enhanced compared to individuals of unrupture plaques group（P0.01）.There was no significant difference in serum levels of PAPP-A between unrupture plaques group and stable plaques group.There was no significant difference in serum levels of MPO between unrupture plaques group and rupture plaques group.The level of serum MPO and PAPP-A was positively correlated with the stability of carotid plaques.Conclusions There was a relationship between the serum MPO,PAPP-A and the instability of carotid plaques.High serum levels of the markers may indicate that the plaques were vulnerable or ruptured.