关键词: 脂蛋白相关磷脂酶A2, 脑卒中, 动脉粥样硬化

Abstract:

Objective　To investigate the changes of lipoprotein-associated phospholipase A2 (Lp-PLA2) level in patients with stroke,and to research the correlation with the volume of cerebral infarction and the severity of neurological impairment in patients with ischemic stroke. Methods　A total of 180 ischemic stroke patients,165 hemorrhagic stroke patients and 105 healthy subjects (healthy control group) were enrolled. By enzyme-linked immunosorbent assay (ELISA),the plasma Lp-PLA2 levels were determined,and the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of Lp-PLA2 in the diagnosis of ischemic stroke and hemorrhagic stroke. The blood lipids [total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)],glucose (Glu) and fibrinogen (FIB) were determined. The volumes of cerebral infarction were measured by cranium magnetic resonance imaging,and the severities of neurological impairment were assessed by the National Institutes of Health Stroke Scale.The correlation of plasma Lp-PLA2 with the National Institutes of Health Stroke Scale was analyzed. Results　The levels of Lp-PLA2,TC,HDL-C,LDL-C and FIB among ischemic stroke,hemorrhagic stroke and healthy control groups had statistical significance (P<0.05). TG and Glu had no statistical significance between ischemic stroke and hemorrhagic stroke groups (P=0.133 and 0.067),and there were statistical significance with those in healthy control group(P<0.05). The area under the ROC curve (AUC) was 0.905,and the optimal cut-off value was 42.35 μg/L. The diagnostic sensitivity and specificity of plasma Lp-PLA2 were 81.5% and 80.0%. Plasma Lp-PLA2 increased with the increase of the volume of cerebral infarction,but it had no statistical significance(H=0.372,P=0.719).Spearman correlation analysis showed that plasma Lp-PLA2 had significant correlation with the National Institutes of Health Stroke Scale(P<0.05). Conclusions　Plasma Lp-PLA2 increases significantly in patients with ischemic stroke,and it is significantly correlated with the National Institutes of Health Stroke Scale. Plasma Lp-PLA2 is an independent risk factor for ischemic stroke,and it may be a prediction index of ischemic stroke and a useful parameter for the severity of patient's condition.

Key words: Lipoprotein-associated phospholipase A2, Stroke, Atherosclerosis