急性缺血性脑卒中患者血浆Lp-PLA2水平与颈动脉硬化斑块稳定性及神经功能缺损程度的关系

doi:10.3969/j.issn.1673-8640.2013.10.005

检验医学 ›› 2013, Vol. 28 ›› Issue (10): 885-889.DOI: 10.3969/j.issn.1673-8640.2013.10.005

急性缺血性脑卒中患者血浆Lp-PLA2水平与颈动脉硬化斑块稳定性及神经功能缺损程度的关系

龙璐，王钟明，陈贞，陶亚，王堃，易斌

中南大学湘雅医院检验科，湖南长沙410008

收稿日期:2013-07-02 出版日期:2013-10-30 发布日期:2013-10-29
通讯作者: 易斌，联系电话:0731-89753200。
作者简介:龙璐，女，1988年生，学士，主要研究方向临床生物化学检验。

The relationship of plasma Lp-PLA2 level with the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with acute ischemic stroke

LONG Lu,WANG Zhongming,CHEN Zhen,TAO Ya,WANG Kun, YI Bin.

Department of Clinical Laboratory,Xiangya Hospital,Central South University,Hunan Changsha 410008,China

Received:2013-07-02 Online:2013-10-30 Published:2013-10-29

摘要/Abstract

摘要：

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平与急性缺血性脑卒中患者颈动脉粥样硬化斑块稳定性及神经功能缺损程度的关系。

关键词: 脂蛋白相关磷脂酶A2, 缺血性脑卒中, 斑块稳定性

Abstract:

Objective To investigate the relationship of plasma lipoprotein-associated phospholipase A2(Lp-PLA2) level with the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with acute ischemic stroke. Methods According to the results of cervical vascular color Doppler ultrasound examination,106 patients with acute ischemic stroke were classified into unstable plaque group(44 cases),stable plaque group(38 cases)and non-plaque group(24 cases). A total of 40 healthy subjects were enrolled as healthy controls. Plasma Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay (ELISA),and the severity of neurological impairment were assessed by the National Institute of Health Stroke Scale(NIHSS) score. Results Compared with the healthy controls,the level of plasma Lp-PLA2 was significantly higher in patients with acute ischemic stroke (Z=-6.995,P<0.05). Plasma levels of Lp-PLA2 in stable plaque group and unstable plaque group were significantly higher than those in non-plaque group with statistical significance (Z=-5.670,P<0.05). Plasma levels of Lp-PLA2 in unstable plaque group were significantly higher than those in stable plaque group with statistical significance (Z=-6.185,P<0.05). According to the results of receiver operating characteristic (ROC) curve,the best cut-off value of Lp-PLA2 was 137.00 μg/L. The sensitivity was 81.8%, and the specificity was 95.1%. The severity of neurological impairment increased with the levels of plasma Lp- PLA2(χ²=74.233,P<0.05). The NIHSS score was positively correlated with the levels of plasma Lp-PLA2(r_s=0.861,P<0.05). Conclusions The level of plasma Lp-PLA2 is related to the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with acute ischemic stroke. Plasma Lp-PLA2 can serve as a predictive indicator of carotid artery atherosclerotic plaque stability.Meanwhile,it plays an important role in monitoring the conditions of patients with acute ischemic stroke.

Key words: Lipoprotein-associated phospholipase A2, Ischemic stroke, Plaque stability

中图分类号:

Q556

龙璐，王钟明，陈贞，陶亚，王堃，易斌. 急性缺血性脑卒中患者血浆Lp-PLA2水平与颈动脉硬化斑块稳定性及神经功能缺损程度的关系[J]. 检验医学, 2013, 28(10): 885-889.

LONG Lu,WANG Zhongming,CHEN Zhen,TAO Ya,WANG Kun, YI Bin.. The relationship of plasma Lp-PLA2 level with the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with acute ischemic stroke[J]. , 2013, 28(10): 885-889.

参考文献

[1] 姜玉章,王兵,李前辉,等. C反应蛋白基因多态性与超敏C反应蛋白的关系及其与缺血性脑卒中的关联研究[J].检验医学,2013,28(2):102-105.
[2] Talelli P,Terzis G,Katsoulas G,et al.Recurrent stroke: the role of common carotid artery intima-media thickness[J]. J Clin Neuroscj,2007,14(11): 1067-1072.
[3] D′Onofrio M,Mansueto G,Faccioli N,et al. Doppler ultrasound and contrast-enhanced magnetic resonance angiography in assessing carotid artery stenosis[J]. Radiol Med,2006,111(1):93-103.
[4] Khakpour H,Frishman WH.Lipoprotein-associated phospholipase A2 : an independent predictor of cardiovascular risk and a novel target for immuno-modulation therapy[J]. Cardiol Rev,2009,17(5):222- 229.
[5] Tsimikas S,Mallat Z,Talmud PJ,et al.Oxidation-specific biomarkers,lipoprotein (a),and risk of fatal and nonfatal coronary events[J]. J Am Coll Cardiol, 2010,56(12):946-955.
[6] 邬建民,张力. 脂蛋白相关磷脂酶A2在冠心病患者严重程度评估中的应用[J]. 检验医学,2011,26(2):85-87.
[7] Jenny NS,Solomon C,Cushman M,et al. Lipoprotein-associated phospholipase A(2) (Lp- PLA(2))and risk of cardiovascular disease in older adults: results from the Cardiovascular Health Study[J].Atherosclerosis,2010,209(2): 528-532.
[8] Mannheim D,Herrmann J,VersariD,et al.Enhanced expression of Lp-PLA2 and lysophosphatidylcholine in symptomatic carotid atherosclerotic plaques[J]. Stroke,2008,39(5): 1448-1455.
[9] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146-153.
[10] Zalewski A,Macphee C.Role of lipoprotein-associated phospholipase A2 in atherosclerosis: biology,epidemiology,and possible therapeutic target[J].Arterioscler Thromb Vasc Biol,2005,25(5):923-931.
[11] 张微微,周小英,黄勇华.不同类型脑梗死患者血清C-反应蛋白的检测及临床意义[J].中华检验医学杂志,2004,27(11):781-783.
[12] Lavi S,McConnell JP,Rihal CS,et al.Local production of lipoprotein-associated phospholipase A2 and lysophosphatidylcholine in the coronary circulation: association with early coronary atherosclerosis and endothelial dysfunction in humans [J]. Circulation,2007,115(21):2715-2721.
[13] Koenig W,Twardella D,Brenner H,et al.Lipo-protein-associated phospholipase A2 predicts future cardiovascular events in patients with coronary heart disease independently of traditional risk factors,markers of inflammation,renal function,and hemodynamic stress[J]. Arterioscler Thromb Vasc Biol,2006,26(7): 1586-1593.
[14] 郭旭,华川,李伟中,等. 脂蛋白相关磷脂酶A2、缺血修饰蛋白在动脉硬化性脑梗死的应用价值[J].临床军医杂志,2012,40(5):1102-1104.
[15] Wei-hua L,Jun-yu H,Chang-qing S,et al. Study on the relationship of cPLA2,CK-MB,and membrane phospholipid content in acute myocardial infarction[J].Heart Vessels,2011,26( 1) : 64-68.
[16] 廖玉华.预测冠状动脉易损斑块新的炎症标志物: 脂蛋白相关磷脂酶A2[J].临床心血管病杂志,2009,25(7): 481-482.
[17] Menschikowski M,Kasper M,Lattke P,et al. Secre-tory group Ⅱ phospholipase A2 in human atherosclerotic plaques[J]. Atherosclerosis,1995,118(2):173-181.
[18] Sarlon-Bartoli G,Boudes A,Buffat C,et al. Circulating lipoprotein-associated phospholipase A2 in high-grade carotid stenosis: a new biomarker for predicting unstable plaque[J]. Eur J Vasc Endovasc Surg,2012,43(2):154-159.
[19] Corson MA,Jones PH,Davidson MH. Review of the evidence for the clinical utility of lipoprotein-associated phospholipase A2 as a cardiovascular risk marker[J]. Am J Cardiol,2008,101(12A): 41F-50F.
[20] Del Zoppo GJ,Mabuchi T. Cerebral microvessel responses to focal ischemia [J].J Cereb Blood Flow Metab,2003,23(8):879-894.

急性缺血性脑卒中患者血浆Lp-PLA2水平与颈动脉硬化斑块稳定性及神经功能缺损程度的关系

The relationship of plasma Lp-PLA2 level with the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with acute ischemic stroke

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