血脂正常的脑梗死患者血浆Lp-PLA2水平表达的临床意义

Plasma Lipoprotein-associated Phospholipase A2 Level and its Clinical Significance in Patients With Cerebral Infarction at Normal Blood Lipids Level

目的通过检测血脂正常的脑梗死患者血浆脂蛋白相关磷脂A2(Lp-PLA2)水平,探讨Lp-PLA2水平与脑梗死体积以及神经功能缺损程度的关系,为评价血脂正常的脑梗死患者的病情提供帮助。方法通过随机抽样方式选取2015年2月—2017年2月于本院接收的脑卒中患者80例作为研究对象,其中发病时间均小于48 h,并且血脂均为正常范围内。另选取门诊80例健康体检者作为对照组。测定血清中的Lp-PLA2浓度,和血清中低密度胆固醇(LDL-C)、高密度胆固醇(HDL-C)、C反应蛋白(CRP)以及总胆固醇(TC)的浓度。结果对照组血清中Lp-PLA2浓度为(168.57±28.36)μg/L,实验组血清中Lp-PLA2浓度为(229.67±24.73)μg/L,两组Lp-PLA2浓度比较,差异有统计学意义(P<0.05)。实验组三组血浆Lp-PLA2水平比较,差异无统计学意义(P>0.05)。不同NIHSS评分的Lp-PLA2水平差异有统计学意义(P<0.05)。并且随着NIHSS评分的升高,Lp-PLA2的浓度越高。Lp-PLA2水平与LDL-C、NIHSS评分呈正相关,与TC、HDL-C以及CRP呈负相关。结论血脂正常的脑梗死患者Lp-PLA2水平是一种与脑梗死相关的重要物质。并且Lp-PLA2能够促进动脉粥样硬化,增加脑梗死的风险,血脂正常的脑梗死患者Lp-PLA2水平显著增高,和脑梗死体积无相关性。

Objective To investigate the changes of lipoprotein-associated phospholipase A2 （Lp-PLA2） level, and to explore the relationship between the level of Lp-PLA2 and cerebral infarction volume and the degree of nerve function defect to evaluate blood lipids of patients with cerebral infarction. Methods From February 2015 to February 2017, 80 cases of cerebral apoplexy patientsin in our hospital were as the research object by random sampling method, the onset time was less than 48 h and blood lipid were at the normal range. An alternate selection outpatient service 80 healthy physical examination as control group. Concentration of serum Lp-PLA2, and serum low density cholesterol （LDL - C）, high density cholesterol （HDL - C） and c-reactive protein （CRP） and the concentration of total cholesterol （TC） were measured. Results The control group in serum concentration of Lp-PLA2 was （168.57±28.36）μg/L, the serum concentration of Lp-PLA2 in the investigation group was （229.67±24.73）μg/L, the concentration of Lp-PLA2 was significantly different between two group （P〈0.05）. The plasma Lp-PLA2 level of three groups in experiment group was no significantly different （P〉0.05）. The Lp-PLA2 level of different NIHSS score was significantly different （P〈0.05）. And with the increase of NIHSS score, the level of Lp-PLA2 was higher. Lp- PLA2 level were positively correlated with LDL - C, NIHSS scores, and was negatively correlated with TC, HDL-C and CRP. Conclusion The Lp-PLA2 level is a important material for blood lipids of patients with cerebral intarction. The Lp-PLA2 can promote atherosclerosis, and increase the risk of cerebral infarction.The increased Lp-PLA2 level has no impact on cerebral infarction volume.