血清脂蛋白相关磷脂酶A2与颅内外动脉粥样硬化性大动脉狭窄的相关性

Correlation between serum lipoprotein associated phospholipase A2 andintracranial/extracranial atherosclerotic large arterial stenosis

目的:探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)与颅内外动脉粥样硬化性大动脉狭窄相关性.方法:选取500例行数字减影血管造影(DSA)或计算机体层血管成像(CTA)的中老年脑血管疾病患者为研究对象,存在≥50%颅内/外大动脉狭窄的193例患者设为观察组,排除存在≥50%的颅内/外大动脉狭窄的307例患者设为对照组.检测两组患者血清Lp-PLA2以及高敏C反应蛋白(hs-CRP)、空腹血糖(GLU)、脂质指标[甘油三酯(TG)、血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、LDL-C/HDL-C、脂蛋白a]、血浆D-二聚体(D-D)、血清同型半胱氨酸(HCY)水平变化,并对Lp-PLA2与颅内外动脉粥样硬化性大动脉狭窄进行相关性分析.同时比较193例观察组中颅内、颅外动脉狭窄患者之间血清Lp-PLA2水平.结果:观察组Lp-PLA2、GLU、LDL-C、LDL-C/HDL-C、脂蛋白a、HCY显著高于对照组(P<0.05),观察组年龄及男性、高血压病史、糖尿病史、吸烟史的占比明显高于对照组(P<0.05);血清Lp-PLA2水平升高、血清GLU、LDL-C、动脉硬化指数、脂蛋白a、HCY升高、男性、年龄增长、有高血压史、有糖尿病史、有吸烟史与颅内外动脉粥样硬化性大动脉狭窄发生呈明显正相关(OR分别为1.004、1.138、1.402、1.609、1.001、1.028、1.645、1.076、2.503、2.383、1.608,P<0.05).颅内狭窄和颅外狭窄患者之间的血清Lp-PLA2水平无统计学差异(P>0.05).结论:血清Lp-PLA2可能为颅内外动脉粥样硬化性大动脉狭窄的独立预测因子.

Objective:To explore the correlation between serum lipoprotein-associated phospholipase A2(Lp-PLA2)with intracranial/extracranial atherosclerotic large arterial stenosis.Method:A total of 500 middle-aged and elderly patients with cerebrovascular disease who underwent DSA or CTA were selected,193 patients with≥50%intracranial/external arterial stenosis were set as the observation group,and 307 patients without≥50%intracranial/external arterial stenosis as the control group.The levels of serum lipoprotein associated phospholipase A2(Lp-PLA2),high-sensitivity c-reactive protein(hs-CRP),fasting blood glucose(GLU),lipid index[triglyceride(TG),serum total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),LDL-C/HDL-C,lipoprotein a],plasma D-dimer(D-D),serum homocysteine(HCY)of patients from two groups were detected,and the correlation between Lp-PLA2 and intracranial/extracranial atherosclerotic large arterial stenosis was analyzed.Serum Lp-PLA2 levels were compared between patients with intracranial and with extracranial artery stenosis in the observation group of 193 cases.Results:In the observation group,the levels of Lp-PLA2,GLU,LDL-C,LDL-C/HDL-C,lipoprotein a and HCY were significantly higher than those in the control group(P<0.05).The age,proportion of male,history of hypertension,diabetes and smoking were significantly higher in the observation group than those in the control group(P<0.05).Increase of Lp-PLA2,GLU,LDL-C,arterial stiffness index,lipoprotein a,HCY,age and proportion of male,and history of hypertension,diabetes and smoking were positively correlated with occurrence of intracranial/extracranial atherosclerotic large arterial stenosis(OR=1.004,1.138,1.402,1.609,1.001,1.028,1.645,1.076,2.503,2.383,1.608;P<0.05).There was no significant difference in serum Lp-PLA2 level between patients with intracranial stenosis and extracranial stenosis(P>0.05).Conclusion:Serum Lp-PLA2 may be used as an independent predictor of intracranial/extracranial atherosclerotic large arterial stenosis.