Lp-PLA_(2)、25(OH)D水平与颈动脉斑块者缺血性脑卒中表现的关系及临床价值研究

The Relationship Between Lp-PLA_(2) and 25(OH)D Levels and Ischemic Stroke Manifestations in Carotid Plaque Patients and Their Clinical Values

目的讨论血清Lp-PLA_(2)、25(OH)D水平与颈动脉狭窄程度>70%的颈动脉斑块患者脑缺血表现的关系。方法选取2021年1月至2022年1月入院并计划进行颈动脉支架手术(颈动脉狭窄程度>70%)的45例患者作为研究对象。采集基础资料、临床特征、肌酐、总胆固醇、三酰甘油、C反应蛋白、同型半胱氨酸、血浆脂蛋白相关磷脂酶A_(2)(LP-PLA)、维生素D[25(OH)D],将颈动脉斑块合并同侧大脑缺血者定义为有症状的颈动脉斑块患者,分为有症状组和无症状组,比较以上因子的水平,分析有无症状与以上因素的相关性。结果有症状组和无症状组中糖尿病、下肢动脉硬化患者数量差异有统计学意义(P<0.05),C反应蛋白水平差异有统计学意义(P<0.05),症状组血清Lp-PLA2水平明显升高,显著高于无症状患者(P<0.05);有症状者血清25(OH)D水平较低,显著低于无症状者(P<0.05)。结论有脑缺血表现的患者的血清Lp-PLA_(2)水平更高,25(OH)D缺乏更明显。

Objective To evaluate the relationship between serum Lp-PLA_(2),25(OH)D levels and cerebral ischemia in patients with carotid plaque with carotid stenosis>70%.Methods From January,2021 to January,2022,45 patients who were admitted to hospital and planned to undergo carotid artery stenting(carotid artery stenosis>70%)were selected as study subjects.We collected patients’basic data,clinical characteristics,measures of creatinine,total cholesterol,triglyceride,C-reactive protein,homocysteine,plasma lipoprotein associated phospholipase A_(2)(LP-PLA_(2)),and vitamin D[25(OH)D].We also defined carotid plaque patients with ipsilateral cerebral ischemia as symptomatic carotid plaque patients,and divided them into symptomatic and asymptomatic groups.We then compared levels of the above factors,and analyzed the correlation between symptomatic and above factors.Results There was a significant difference in the number of patients with diabetes and lower extremity atherosclerosis between the symptomatic group and the asymptomatic group(P<0.05),and there was a significant difference in the level of C-reactive protein(P<0.05).The level of serum Lp-PLA_(2) in the symptomatic group was significantly higher than that in the asymptomatic group(P<0.05);Serum 25(OH)D level in symptomatic patients was lower than that in asymptomatic patients(P<0.05).Conclusion The level of serum Lp-PLA_(2) is higher in patients with cerebral ischemia,and the level of 25(OH)D deficiency is more severe.