急性脑梗死患者脑血流中微栓子与脂蛋白相关磷脂酶A2的相关性研究

Correlation between microemboli and lipoprotein-associated phospholipase A2 in patients with acute cerebral infarction

目的研究急性脑梗死患者脑血流中微栓子与脂蛋白相关磷脂酶A2（LP—PLA2）的相关性。方法选择192例研究对象，其中112例为发病48h内颈内动脉或大脑中动脉区域急性脑梗死患者，行经颅多普勒超声检测微栓子信号（MES），根据检测结果分为MES阳性组（42例）和MES阴性组（70例）；80例为非脑血管病患者（对照组），无脑血管病史，且无明显颅内外动脉狭窄。均采用酶联免疫吸附法定量血清LP-PLA2水平。结果对照组LP-PLA2（20．09±7．27）μg／L，MES阴性组LP-PLA2（47．70±23．86）μg／L，两组比较差异有统计学意义（P〈0．01）。MES阳性组LP-PLA2（59．45±19．51）μg/L，与对照组比较差异有统计学意义（P〈0．01），与MES阴性组比较差异有统计学意义（P〈0．05）。高血压、高脂血症、LP-PLA2与脑梗死的发生呈正相关（P〈0．05）。结论LP．PLA2与动脉硬化斑块的不稳定性相关，微栓子及LP-PLA2是发生脑梗死的危险因素。

Objective To investigate the relationship between microemboli and lipoprotein-assoeiated phospholipase A2 （LP-PLA2） in patients with acute cerebral infarction. Methods One hundred and ninety two patients were selected, among whom 112 patients were acute cerebral infarction in internal carotid or middle cerebral arterial area within 48 hours. The microemboli signal （MES） was measured by transeranial Doppler sonography. The patients were divided into MES positive group （42 cases） and MES negative group （70 cases） according the measured method; 80 patients without cerebrovascular disease were as control group （they had no the histories of cerebral vascular diseases and internal and external carotid artery stenosis）. The serum LP-PLA2 levels were measured by enzyme linked immunosorbent assay. Results The LP-PLA2 in control group was （20.09± 7.27） μ g/L, in MES negative group was （47.70 ± 23.86）μg/L, and there was statistical difference （P 〈 0.01）. The LP-PLA2 in MES positive group was （59.45±19.51）μg/L, and there was statistical difference compared with control group （P 〈 0.01）, and there was statistical difference compared with MES negative group （P 〈 0.05）. There was positive correlation between hypertension, hyperlipemia, LP-PLA2 and cerebral infarction （P 〈 0.05）. Conclusions LP-PLA2 relates to instability of atherosclerotic plaque. Microemboli and LP-PLA2 levels are risk factors for cerebral infarction.