Clinical application of serum lipoprotein-associated phospholipase A2 level in patients with acute cerebral infarction

doi:10.3969/j.issn.1673-8640.2020.02.008

Abstract

Abstract:

Objective To investigate the relationship between serum lipoprotein-associated phospholipase A₂（Lp-PLA₂） activity and the location,severity and recurrence risk of cerebral atherosclerosis（CAS） in patients with acute cerebral infraction（ACI）. Methods A total of 186 ACI patients were enrolled. Serum Lp-PLA₂ activity,total cholesterol（TC）,triglyceride（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）,homocysteine（Hcy） and high-sensitivity C-reactive protein（hs-CRP） were determined. The location and severity of CAS were measured by computed tomography angiography（CTA） or magnetic resonance angiography（MRA） and carotid ultrasound. Spearman correlation analysis was used to evaluate the correlation of these parameters with CAS. Results Serum Lp-PLA₂ activity of vulnerable plaque group was higher than those of stable plaque group and no plaque group （P<0.05）,while hs-CRP and Hcy showed no statistical significance in the 3 groups （P>0.05）. Serum Lp-PLA₂ activities in stenosis group and occlusion group were higher than that in non-stenosis group （P<0.05）. The occlusion group had higher hs-CRP than that in non-stenosis group （P<0.05）. Serum hs-CRP and Lp-PLA₂ activity in CAS stenosis group were higher than those in non-CAS stenosis group （P<0.05）. Age,the proportions of hypertension,heart disease and diabetes,as well as hs-CRP level in relapse group were higher than those in non-relapse group （P<0.05）. There was no statistical significance for the proportion of males,TC,TG or Lp-PLA₂（P>0.05）. Spearman analysis showed that Lp-PLA₂ activity,TC,LDL-C and hs-CRP had positive correlations with CAS（r=0.378,0.229,0.229 and 0.163,respectively,P<0.05）. The areas under receiver operating characteristic（ROC） curves （AUC） of Lp-PLA₂ activity,TC,LDL-C and hs-CRP to diagnose CAS were 0.801,0.683,0.683 and 0.584,respectively,and the optimal cut-off value was 489.5 U/L. Conclusions Serum Lp-PLA₂ activity is related with CAS severity,and it can reflect the severity in ACI patients.

Key words: Lipoprotein-associated phospholipase A₂, Cerebral atherosclerosis, Acute cerebral infraction

CLC Number:

R446.1

LU Yide, WU Jianing, PENG Yibing. Clinical application of serum lipoprotein-associated phospholipase A₂ level in patients with acute cerebral infarction[J]. Laboratory Medicine, 2020, 35(2): 129-133.

Figures/Tables 6

References 18

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组别	例数	hs-CRP/（mg/L）	Hcy/（μmol/L）	Lp-PLA_2/（U/L）
无斑块组	37	2.33（0.87~4.36）	10.3（8.4~12.0）	481±130^*
稳定斑块组	28	5.28（1.04~8.77）	12.0（9.7~15.6）	489±102^*
易损斑块组	95	2.58（1.17~8.52）	11.9（9.2~14.8）	550±115

组别	例数	hs-CRP/（mg/L）	Hcy/（μmol/L）	Lp-PLA_2/（U/L）
无斑块组	37	2.33（0.87~4.36）	10.3（8.4~12.0）	481±130^*
稳定斑块组	28	5.28（1.04~8.77）	12.0（9.7~15.6）	489±102^*
易损斑块组	95	2.58（1.17~8.52）	11.9（9.2~14.8）	550±115

组别	例数	hs-CRP/（mg/L）	Hcy/（μmol/L）	Lp-PLA_2/（U/L）
无狭窄组	37	1.79（0.87~3.71）	11.5（8.7~13.0）	444±114
狭窄组	92	3.43（1.17~8.32）	11.9（9.0~15.4）	542±110^*
闭塞组	31	4.17（0.99~11.62）^*	11.3（9.2~14.6）	563±115^*

组别	例数	hs-CRP/（mg/L）	Hcy/（μmol/L）	Lp-PLA_2/（U/L）
无狭窄组	37	1.79（0.87~3.71）	11.5（8.7~13.0）	444±114
狭窄组	92	3.43（1.17~8.32）	11.9（9.0~15.4）	542±110^*
闭塞组	31	4.17（0.99~11.62）^*	11.3（9.2~14.6）	563±115^*

组别	例数	hs-CRP/（mg/L）	Hcy/（μmol/L）	Lp-PLA₂/（U/L）
无CAS性狭窄组	37	1.79（0.87~3.52）	11.5（8.7~13.0）	442±114
颅外CAS性狭窄组	15	4.99（1.54~7.16）	14.1（11.3~15.9）	501±84
颅内CAS性狭窄组	24	2.52（0.98~12.94）	10.6（8.7~14.6）	491±92
并发颅内外CAS性狭窄组	84	3.86（1.21~8.78）^*	11.9（9.2~14.5）	575±112^*

Clinical application of serum lipoprotein-associated phospholipase A₂ level in patients with acute cerebral infarction

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组别	例数	年龄/岁		男性/例（%）	高血压/例（%）		心脏病/例（%）		糖尿病/例（%）
不易复发组	28	59.29±11.19		16（57.10）	9（34.60）		2（7.70）		3（10.70）
易复发组	158	70.03±11.81		109（69.00）	131（83.40）		46（29.50）		64（40.50）
统计值		-4.471		1.024	26.926		4.387		7.913
P值		0.000		0.312	0.000		0.036		0.005
组别	TC/（mmol/L）		TG/（mmol/L）			hs-CRP/（mg/L）		Lp-PLA_2/（U/L）
不易复发组	4.72（4.12~5.27）		1.25（0.99~1.78）			1.73（0.78~5.04）		525±133
易复发组	4.40（3.90~5.26）		1.28（1.00~1.83）			3.06（1.13~8.70）		526±123
统计值	-0.362		-0.209			1.967		-0.037
P值	0.717		0.834			0.049		0.970

项目	AUC（95%可信区间）	最佳临界值	敏感性/%	特异性/%	约登指数
Lp-PLA₂	0.801（0.721~0.880）	489.5 U/L	69.9	80.0	0.499
TC	0.683（0.585~0.781）	3.99 mmol/L	81.6	50.0	0.316
LDL-C	0.683（0.587~0.779）	2.37 mmol/L	76.8	61.1	0.379
hs-CRP	0.584（0.476~0.692）	5.59 mg/L	36.0	80.6	0.166

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