急性期脑梗死血浆脂蛋白相关磷脂酶A2与颅内动脉狭窄的相关性研究

Study on the relationship between plasma lipoprotein-related phospholipase A2 and intracranial arterial stenosis in acute cerebral infarction

目的研究急性期脑梗死患者血浆脂蛋白相关磷脂酶A2的表达水平,分析其与颅内动脉狭窄的相关性。方法选择2015年1月至2016年1月在本院治疗并确诊为伴颅内动脉狭窄的急性期脑梗死患者164例,1随机分成观察组A(颅内动脉狭窄微栓子信号阳性组)84例和观察组B(颅内动脉狭窄微栓子信号阴性组)80例,2根据血管狭窄率将164例颅内动脉狭窄患者分为轻度狭窄组、中度狭窄组、重度狭窄组;分别与正常对照组进行对比,观察所有患者的病变血管分布、Lp-PLA2浓度、血脂浓度、脑梗死体积。结果颅内动脉狭窄脑梗死病变血管主要为大脑中动脉(35.4%);随着血管狭窄程度增加,Lp-PLA2浓度升高;颅内动脉狭窄脑梗死患者的血清Lp-PLA2浓度升高,微栓子阳性组升高较阴性组明显,LDL浓度与Lp-PLA2浓度相关,各项差异有统计学意义。结论 Lp-PLA2与颅内动脉狭窄程度相关,与斑块稳定性相关,Lp-PLA2水平增高可升高心脑血管疾病,其特异性高,是脑梗死风险的强有力指标。

Objective To study the expression of plasma lipoprotein-related phospholipase A2 （APL） in patients with acute cerebral infarction （ACI）, and to analyze its correlation with intracranial artery stenosis. Methods 164 patients with acute cerebral infarction admitted in our hospital from January, 2015 to January, 2016 were randomly divided into observation group A （intracranial arterial stenosis and microembolic signal positive group） （n= 84） and observation group B （80 cases）. （2） According to the stenosis rate, 164 patients with intracranial arterial stenosis were divided into mild stenosis group, moderate stenosis group and severe stenosis group. The blood vessel distribution, Lp-PLA2 concentration, blood lipid concentration and cerebral infarct volume were observed in all the patients, compared with the normal control group. Results The intracranial arterial stenosis was mainly caused by the middle cerebral artery （35.4%）. The concentration of Lp- PLA2 increased with the increase of stenosis. The concentration of Lp-PLA2 in the patients with cerebral infarction was higher, the levels of LDL and Lp-PLA2 were significantly higher in the embolus positive group than in the negative group, and the difference was statistically significant. Conclusions Lp-PLA2 is associated with stenosis degree of intracranial arteries, and is associated with plaque stability. Elevated Lp-PLA2 level can elevate cardiovascular and cerebrovascular diseases. Its specificity is high and it is a powerful indicator of cerebral infarction risk.