急性前循环脑梗死患者血浆脂蛋白相关磷脂酶A2活性与颈内动脉狭窄的关系

Relationship between plasma lipoprotein-associated phospholipase A2 activity and internal carotid artery stenosis in patients with acute anterior circulation cerebral infarction

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)活性与急性前循环脑梗死患者颈内动脉狭窄的关系。方法采用CTA检查133例急性前循环脑梗死患者的颈内动脉狭窄的程度,将其分为轻-中度狭窄组及重度狭窄组。收集133例患者及70名正常对照者(正常对照组)的临床资料,并采用速率法检测血浆Lp-PLA2活性。结果重度狭窄组高血压、糖尿病比率显著高于轻-中度狭窄组(P=0.039,P<0.001)及正常对照组(P=0.016,P<0.001)。轻-中度狭窄组高血压、糖尿病比率显著高于正常对照组(P=0.004,P=0.003)。与重度狭窄组比较,轻-中度狭窄组(P=0.022,P=0.009,P=0.008)及正常对照组(P=0.012,P=0.007,P=0.001)总胆固醇、低密度脂蛋白胆固醇水平及Lp-PLA2活性显著降低,三酰甘油、高密度脂蛋白胆固醇水平差异无统计学意义(均P>0.05)。Lp-PLA2活性与急性前循环脑梗死颈内动脉狭窄程度独立相关(P<0.05)。结论 Lp-PLA2活性可以作为预测颈内动脉狭窄程度的指标,较高的Lp-PLA2活性一定程度上提示重度动脉狭窄的存在。

Objective To explore the relationship between plasma lipoprotein-associated phospholipase A2(Lp-PLA2) activity and internal carotid artery stenosis in patients with acute anterior circulation cerebral infarction. Methods CTA was used to determine the degree of internal carotid artery stenosis in 133 patients with acute anterior circulation cerebral infarction. They were divided into mild to moderate stenosis group and severe stenosis group. The clinical data of 133 patients and 70 normal controls(normal control group) were collected and the activity of plasma Lp-PLA2 was detected by rate method. Result The incidence of hypertension, diabetes in the severe stenosis group were significantly higher than those in the mild to moderate stenosis group(P=0.039, P<0.001) and normal control group(P=0.016, P<0.001). The incidence of hypertension, diabetes in the mild to moderate stenosis group were significantly higher than those in the normal control group(P=0.004, P=0.003). Compared with those in the severe stenosis group, the levels of total cholesterol, low density lipoprotein cholesterol and the Lp-PLA2 activity in the mild to moderate stenosis group(P=0.022, P=0.009, P=0.008) and normal control group(P=0.012, P=0.007, P=0.001) were significantly decrease, the levels of triglyceride and high density lipoprotein cholesterol in mild to moderate stenosis group and normal control group had no statistically significant(all P>0.05). Lp-PLA2 activity was an independent risk factor for the degree of internal carotid artery stenosis in patients with acute anterior circulation cerebral infarction(P<0.05). Conclusions Lp-PLA2 activity can be used as an index to predict the degree of internal carotid artery stenosis. The high activity of Lp-PLA2 suggests the possibility of severe internal carotid artery stenosis.