血浆脂蛋白相关磷脂酶A2水平与颈动脉超声斑块稳定性的相关性

Correlation between plasma lipoprotein-associated phospholipase A2 levels and stability of carotid artery ultrasound plaque

目的脂蛋白相关磷脂酶A2(Lp-PLA2)水平的升高是动脉粥样硬化的危险因素。文中探讨血浆Lp-PLA2水平与颈动脉粥样硬化斑块稳定性的相关性。方法选择东部战区总医院2020年6月至2021年3月进行颈动脉超声并发现颈动脉斑块的患者70例,其中男44例、女26例。根据颈动脉超声的表现将患者分为稳定组(n=24)和不稳定组(n=46)。应用二维及彩色多普勒超声对所示斑块进行评估,并检测患者的血浆Lp-PLA2水平。结果不稳定组患者的血浆Lp-PLA2水平显著高于稳定组[(383.38±188.62)μg/mL vs(156.16±81.26)μg/mL,P<0.05]。二元Logistic回归分析结果显示,高水平的Lp-PLA2是影响动脉粥样硬化斑块稳定性的独立风险因素(OR=1.03,95%CI:1.01~1.04,P<0.05)。受试者工作曲线显示,Lp-PLA2评估颈动脉斑块稳定性的最佳截断值为202.97μg/mL,灵敏度为97.8%、特异度为87.5%。结论血浆Lp-PLA2水平与颈动脉粥样斑块稳定性相关,高水平的Lp-PLA2是影响斑块稳定性的独立风险因素,同时可对缺血性脑卒中有一定的预防价值。

Objective Elevated lipoprotein-associated phospholipase A2(Lp-PLA2)is a risk factor for atherosclerosis.To explore the correlation between the plasma lipoprotein-associated phospholipase A2(Lp-PLA2)and the stability of carotid atherosclerotic plaque.Methods a total of 70 patients(44 males and 26 females)with carotid artery plaque were selected for carotid artery ultrasound from June 2020 to March 2021 in Tongren Rehabilitation Hospital of Wuxi.Patients were divided into stable group(n=24)and unstable group(n=46)according to carotid ultrasound findings.Two dimensional and color Doppler ultrasonography were used to assess the plaques and the plasma levels of Lp-PLA2 were detected.Results The level of plasma Lp-PLA2 in unstable group was significantly higher than that in stable group[(383.38±188.62)μg/mL vs(156.16±81.26)μg/mL,P<0.05].Binary Logistic regression analysis showed that high level of Lp-PLA2 was an independent risk factor for atherosclerotic plaque stability(OR=1.03,95%CI:1.01-1.04,P<0.05).The optimal cut-off value of Lp-PLA2 was 202.97μg/mL,the sensitivity was 97.8%,the specificity was 87.5%.Conclusion The level of plasma Lp-PLA2 is correlated with the stability of carotid atherosclerotic plaque.High level of Lp-PLA2 is an independent risk factor affecting the stability of carotid atherosclerotic plaque,and has certain preventive value for ischemic stroke.