脂蛋白相关磷脂酶A2与脑梗死患者颈部动脉粥样硬化斑块的关系

The Relationship between Serum Lipoprotein-Associated Phospholipase A2 and hs-CRP Level and Carotid Artery Plaque in Patients with Cerebral Infarction

目的探讨脑梗死患者血清脂蛋白相关磷脂酶A2(lipoprotein-relatedphospholipaseA2,Lp-PLA2)及超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平与颈部动脉粥样硬化性斑块的关系。方法选择2017年1月-2018年3月郑州市第三人民医院诊断为脑梗死的患者243例,另外选择同期体检的无脑梗死患者120例作为对照组。2组研究对象均检测血清Lp-PLA2、hs-CRP水平。依据颈部动脉超声检查结果将脑梗死患者进一步分为无斑块组、稳定斑块组和易损斑块组。结果①脑梗死患者的血清Lp-PLA2[(180.04±35.02)ng/mL vs(152.13±39.67)ng/mL,P=0.014]、hs-CRP[(10.02±0.47)mg/L vs(2.64±0.33)mg/L,P=0.017]水平高于对照组。②稳定斑块组[(162.96±11.34)ng/mL,P=0.013]和易损斑块组[(197.79±32.56)ng/mL,P=0.004]Lp-PLA2水平高于无斑块组[(143.67±12.35)ng/mL];易损斑块组Lp-PLA2水平高于稳定斑块组(P=0.007),差异均有统计学意义。③易损斑块组血清hs-CRP水平[(12.86±1.67)mg/L]高于稳定斑块组[(10.82±0.53)mg/L,P=0.029]及无斑块组[(9.54±0.47)mg/L,P=0.037],差异有统计学意义。结论在脑梗死患者中,血清Lp-PLA2与hs-CRP可能与颈部动脉粥样硬化斑块的发生及其不稳定性有关。

Objective To investigate the relationship between serum lipoprotein-related phospholipase A2(Lp-PLA2)and high-sensitivity C-reactive protein(hs-CRP)levels and carotid atherosclerotic plaque in patients with cerebral infarction.Methods 243 patients diagnosed with cerebral infarction in the Third People’s Hospital of Zhengzhou from January 2017 to March 2018 were selected as cerebral infarction group,and 120 subjects without cerebral infarction through physical examination in this hospital during the same period were selected as control group.Serum Lp-PLA2 and hs-CRP levels were detected in the two groups.According to the results of carotid artery ultrasound examination,the patients with cerebral infarction were divided into non-plaque group,stable plaque group and vulnerable plaque group.Results(1)Serum Lp-PLA2 level[(180.04±35.02)ng/mL vs(152.13±39.67)ng/mL,P=0.014]and hs-CRP level[(10.02±0.47)mg/L vs(2.64±0.33)mg/L,P=0.017]in cerebral infarction group were higher than those in control group.(2)Serum Lp-PLA2 level in the stable plaque group[(162.96±11.34)ng/mL vs(143.67±12.35)ng/mL,P=0.013]and vulnerable plaque group[(197.79±32.56)ng/mL vs(143.67±12.35)ng/mL,P=0.004]were both significantly higher than that in the non-plaque group.Serum Lp-PLA2 level in vulnerable plaque group(P=0.007)was higher than that in stable plaque group.(3)Serum hs-CRP level in vulnerable plaque group were higher than that in stable plaque group[(12.86±1.67)mg/L vs(10.82±0.53)mg/L,P=0.029]and nonplaque group[(12.86±1.67)mg/L vs(9.54±0.47)mg/L,P=0.037].Conclusions The serum Lp-PLA2 and hs-CRP level probably predicted the development and instability of carotid artery plaques in patients with cerebral infarction.