人血浆脂蛋白相关磷脂酶A2与脑白质病变的相关性分析

Study on the correlation between plasma lipoprotein associated phospholipase A2 and white matter lesions

目的探讨人血浆脂蛋白相关磷脂酶A2(Lp-PLA2)与脑白质病变(WML)的相关性.方法分析267例自2019年3月至2020年1月在南京医科大学第一附属医院住院的行头颅磁共振(MRI)检查的患者,分为WML组(195例)和非WML组(72例),收集患者一般临床资料和检验、检查指标进行比较分析.将WML组患者按Fazekas量表评估脑室旁(P)-WML和深部(D)-WML病变的严重程度.结果WML组较非WML组在年龄、高血压史、颈动脉内膜中层平均厚度(IMT)、Lp-PLA2等方面有显著差异(P<0.05);多因素Logistic回归分析显示年龄(OR值1.083)、高血压史(OR值2.146)、Lp-PLA2(OR值1.008)与WML的发生明显相关(P<0.05);(P)-WML患者的Lp-PLA2值与无病变患者比较无统计学意义(P>0.05),(D)-WML患者的Lp-PLA2值较无病变者高(P<0.05),WML轻、中、重度患者之间的Lp-PLA2值无明显差异.结论年龄、高血压和Lp-PLA2是WML发生的重要危险因素.Lp-PLA2可能主要影响了(D)-WML的发生,与WML的病变严重程度之间可能不呈浓度依赖性关系.

Objective To explore the correlation between human plasma lipoprotein associated phospholipase A2(Lp-PLA2)and white matter lesions(WML).Methods 267 patients admitted to the First Affiliated Hospital of Nanjing Medical University from March 2019 to January 2020 were analyzed,and head magnetic resonance imaging(MRI)was performed for them.Participants were divided into WML group(195 cases)and non WML group(72 cases).The general clinical data,blood biochemical indication and examination indexes were collected for comparative analysis.The severity of paraventricular(P)-WML and deep(D)-WML lesions was assessed by Fazekas.Results There were significant differences in age,hypertension history,IMT and LpPLA2 between WML group and non WML group(P<0.05);Multivariate Logistic regression analysis showed that age(OR=1.083),hypertension history(OR=2.146)and Lp-PLA2(OR=1.008)were significantly correlated with WML(P<0.05);There was no significant difference in the value of Lp-PLA2 between patients with(P)-WML and patients without pathological changes(P>0.05).The value of Lp-PLA2 in(D)-WML patients was higher than that in non pathological patients(P<0.05).There was no significant difference in the value of Lp-PLA2 between light,medium and severe WML patients.Conclusion Age,hypertension and Lp-PLA2 are the important risk factors of WML.Lp-PLA2 may mainly affects the occurrence of(D)–WML,and may not have a dose dependent relationship with the severity of WML.