脑梗死病人颈动脉粥样硬化斑块性质及神经功能损伤程度与血浆Lp-PLA_(2)水平的关系

Correlation between the Degree of Carotid Atherosclerosis,Plaque Properties,Nerve Function and the Level of Plasma Lp-PLA_(2) in Patients with Cerebral Infarction

目的探讨血浆脂蛋白相关磷脂酶A_(2)(Lp-PLA_(2))水平与脑梗死病人颈动脉粥样硬化斑块性质及神经功能损伤程度的关系。方法选取2017年5月—2019年5月开封市人民医院收治的78例动脉粥样硬化性脑梗死病人为脑梗死组,同期体检的健康志愿者45名作为对照组。检测受试者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)、Lp-PLA_(2)水平,用彩色多普勒超声检查颈动脉斑块情况,计算Crouse积分。结果脑梗死组TC、TG、LDL-C、hs-CRP、Lp-PLA_(2)水平均高于对照组(P<0.05),HDL-C水平低于对照组(P<0.05);血浆Lp-PLA_(2)水平比较:重度神经损伤组>中度神经损伤组>轻度神经损伤组(P<0.05),大体积梗死组>中体积梗死组>小体积梗死组(P<0.05),不稳定斑块组>稳定斑块组(P<0.05);血浆Lp-PLA_(2)水平、Crouse积分比较:斑块分级Ⅲ级>Ⅱ级>Ⅰ级(P<0.05);血浆Lp-PLA_(2)水平与颈动脉粥样硬化斑块Crouse积分呈正相关(r=0.756,P<0.05)。结论脑梗死病人血浆Lp-PLA_(2)水平较健康人群高,其水平随病情加重而增加,随梗死灶体积增加而升高,且与颈动脉斑块稳定性、大小、数量有关,检测血浆Lp-PLA_(2)浓度有助于了解颈动脉粥样硬化的程度。

Objective To explore the relationship between plasma lipoprotein-associated phospholipase A_(2)(Lp-PLA_(2))level and carotid atherosclerotic plaque in patients with cerebral infarction.Methods Seventy-eight patients with atherosclerotic cerebral infarction admitted to our hospital from May 2017 to May 2019 were enrolled as cerebral infarction group,and 45 healthy volunteers in our hospital were enrolled as control group.The total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),high-sensitivity C-reactive protein(hs-CRP),fibrinogen(FIB),and Lp-PLA_(2) were detected,and the carotid plaques were examined by color Doppler ultrasound,andCrouse score were calculated.Results The levels of TC,TG,LDL-C,hs-CRP,and Lp-PLA_(2) in cerebral infarction group were higher than those in control group,while the HDL-C level was lower than that in control group(P<0.05).The plasma Lp-PLA_(2) level showed that in severe nerve injury group>moderate nerve injury group>mild nerve injury group(P<0.05),large-volume infarction group>medium-volume infarction group>small-volume infarction group(P<0.05),and that in unstable plaque group>stable plaque group(P<0.05).The plasma Lp-PLA_(2) level and Crouse score comparison showed that in gradeⅢ>gradeⅡ>gradeⅠ(P<0.05).Plasma Lp-PLA_(2) level was positively correlated with Crouse score of carotid atherosclerotic plaque(r=0.756,P<0.05).Conclusion The level of plasma Lp-PLA_(2) in patients with cerebral infarction is higher than that in healthy people.And its concentration increases with the severity of the disease,and increases with the increase of infarction volume.It is significantly correlated with the stability,size,and quantity of carotid plaque.The concentration of plasma Lp-PLA_(2) helps to understand the carotid atherosclerosis.