急性缺血性脑卒中患者血脂、血清胱抑素C及脂蛋白相关磷脂酶A2水平与颈动脉粥样硬化的关系

Relationship between Serum Lipids,Cystatin C,Lipoprotein Associated Phospholipase A2 and Carotid Atherosclerosis in Patients with Acute Ischemic Stroke

目的:探究急性缺血性脑卒中患者脂蛋白相关磷脂酶(Lp-PLA2)、血清胱抑素(Cys-C)、血脂水平和颈动脉粥样硬化之间存在的关系。方法:选取2015年8月-2020年1月在本院诊治的396例急性缺血性脑卒中患者为研究对象。以颈部超声检查结果为依据,将其分为两组,其中274例归为斑块组,122例归为动脉硬化组,然后再以斑块性质为依据,将斑块组划分两个亚组,188例归为不稳定斑块亚组,86例归为稳定斑块亚组。各组患者均测定Lp-PLA2、Cys-C与血脂水平,经多因素logistic回归分析各项指标和颈动脉粥样硬化之间存在的相关性。结果:相较于动脉硬化组,斑块组低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、血清Lp-PLA2、Cys-C水平更高,高密度脂蛋白胆固醇(HDL-C)水平更低,差异均有统计学意义(P<0.05)。多因素logistic回归分析可知,颈动脉粥样硬化形成的影响因素包括血清Lp-PLA2、Cys-C(P<0.05)。相较于稳定斑块亚组,不稳定斑块亚组LDL-C、TC、血清Lp-PLA2、Cys-C水平更高,HDL-C水平更低,差异均有统计学意义(P<0.05)。经多因素logistic回归分析可知,不稳定斑块形成的影响因素包括血清Lp-PLA2、Cys-C、HDL-C(P<0.05)。结论:急性缺血性脑卒中患者Lp-PLA2、Cys-C水平和颈动脉粥样硬化以及不稳定斑块形成存在密切相关性,HDL-C则和不稳定斑块形成密切相关。

Objective:To explore the relationship between lipoprotein associated phospholipase(Lp-PLA2),serum cystatin C(Cys-C),blood lipid and carotid atherosclerosis in patients with acute ischemic stroke.Method:A total of 396 patients with acute ischemic stroke diagnosed and treated in our hospital from August 2015 to January 2020 were selected as the research subjects.Based on the results of cervical ultrasound,the patients were divided into two groups,of which 274 cases were classified as plaque group and 122 cases were classified as arteriosclerosis group.The plaque group was then divided into two subgroups based on the nature of the plaque,188 cases were classified as unstable plaque subgroup and 86 cases were classified as stable plaque subgroup.Lp-PLA2,Cys-C and blood lipid levels were determined in all groups,and the correlation between various indexes and carotid atherosclerosis was analyzed by multivariate Logistic regression.Result:Compared with arteriosclerosis group,the levels of low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),serum Lp-PLA2 and Cys-C in plaque group were higher,and the level of high density lipoprotein cholesterol(HDL-C)was lower,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the influencing factors of carotid atherosclerosis included serum Lp-PLA2 and Cys-C(P<0.05).Compared with the stable plaque subgroup,the levels of LDL-C,TC,serum Lp-PLA2,Cys-C in the unstable plaque subgroup were higher,and the level of HDL-C was lower(P<0.05).Multivariate logistic regression analysis showed that serum Lp-PLA2,Cys-C and HDL-C were the influencing factors of unstable plaque formation(P<0.05).Conclusion:Lp-PLA2 and Cys-C levels were closely correlated with carotid atherosclerosis and unstable plaque formation in patients with acute ischemic stroke,while HDL-C levels were closely correlated with unstable plaque formation.