急性缺血性脑卒中患者血浆Lp-PLA2 的表达及与斑块稳定性及神经功能缺损的关系

目的：探讨急性缺血性脑卒中患者血浆脂蛋白相关磷脂酶（Lp-PLA2）的表达及与斑块稳定性及神经功能缺损的关系。方法：按照颈动脉彩超结果将2014 年5 月-2015 年1 月我院收治的80 例急性缺血性脑卒中患者分为斑块稳定组（25 例）、斑块不稳定组（39 例）和无斑块组（16 例），并于同期随机抽取120 例健康体检者为对照组。采用散射比浊法测定各组血浆Lp-PLA2，同时采用美国国立卫生研究所中风量表（NIHSS 评分）对三组的神经功能缺损情况进行评估。结果：斑块稳定组、斑块不稳定组以及无斑块组血浆Lp-PLA2 高于对照组，斑块稳定组、斑块不稳定组高于无斑块组，斑块不稳定组高于斑块稳定组，差异均有统计学意义（P<0.05），患者血浆Lp-PLA2水平与动脉粥样硬化斑块的稳定性呈正相关性（rs=0.638，P<0.05）。神经功能缺损中型组、重型组血浆Lp-PLA2 高于轻型组，重型组高于中型组，差异有统计学意义（P<0.05），患者血浆Lp-PLA2 水平与神经功能缺损程度呈正相关性（rs=0.715，P<0.05）。结论：血浆Lp-PLA2 可作为预测急性缺血性脑卒中患者颈动脉硬化斑块稳定性以及评估患者神经功能缺损程度的重要指标。

Relationship of Plasma Lp-PLA2 with the Stability of Carotid ArteryAtherosclerotic Plaque and Severity of Neurological Impairment in Patientswith Acute Ischemic Cerebral Stroke

Objective:To explore the relationship between plasma lipoprotein-associated phospho lipase A2 (Lp-PLA2) andstability of carotid artery atherosclerotic plaque and severity of neurological impairment in patients with acute ischemic cerebral stroke.Methods:80 cases of patients with acute ischemic cerebral stroke were divided into stable plaque group (n=25), unstable plaque group(n=39) and non-plaque group (n=16) according to results of carotid artery ultrasonography,who were treated in our hospital from May2014 to January 2015, and randomly selected 120 healthy volunteers as control group at the same period. Then detected plasma Lp-PLA2level in each group by scattering turbidimetric method,evaluated the degree of neurological impairment by American National Institutesof Health Stroke Scale (NIHSS score) in three patients groups.Results:Plasma Lp-PLA2 levels in stable plaque group, unstable plaquegroup and non-plaque group were higher than control group, and they were higher in stable plaque group and unstable plaque group thannon-plaque group, it was higher in unstable plaque group than stable plaque group,the differences were statistical significant(P<0.05).Plasma Lp-PLA2 level was positively related with the stability of carotid artery atherosclerotic plaque (rs=0.638,P<0.05). PlasmaLp-PLA2 levels in medium and severe type of neurological impairment were higher than light type,and severe type was higher thanmedium type, the differences were statistical significant (P<0.05).Plasma Lp-PLA2 level was positively related with the degree ofneurological impairment (rs=0.715, P<0.05).Conclusion:Plasma Lp-PLA2 level can be regarded as an important indicator to forecast thestability of carotid artery atherosclerotic plaque and evaluate the degree of neurological impairment in patients with acute ischemiccerebral stroke.