Clinical Significance Of Lipoprotein-associated PhospholipaseA2in Cardiovascular And Cerebrovascular Diseases

Objective:To explore the relationship and clinical significance of plasma lipoprotein associated phospholipase A2levels with coronary heart disease and ischemic stroke, Understanding corelation of Lp-PLA2with coronary atherosclerosis severity and stability and blood lipid levels and inflammatory markers.Methods:From March2012to February2013,84CHD cases and36ACI cases were enrolled for the test groups. And31patients who were normal by coronary angiography(CAG) were enrolled for the congtrl group.The84CHD cases were divided into different subgroups by clinical type and number of diseased vessels. All blood samples were collected when the patients’admission. Measuring the Lp-PLA2levels by ELISA, the level of white blood cell (WBC) count, high sensitivity C-reactive protein(hs-CRP),lipids and cardiac markers were measured too.Recording the clinical datas such as age、sex、blood pressure.Results:1There’s statistical significance between the Lp-PLA2levels of the test groups and the control group(P<0.05),there’s no statistical significance between the Lp-PLA2level of the CHD and the ACI, there’s statistical significance in the subgroups of CHD.2The Lp-PLA2levels in single-vessel disease subgroup、double-vessel disease subgroup and three-vessel disease subgroup were higher significantly than that in the control group (P<0.05);The level of Lp-PLA2was higher significantly in three-vessel disease subgroup than that in double-vessel disease subgroup (P<0.05).3The spearman corrrelation analysis showed that the levels of Lp-PLA2had no correlation with the traditional inflammatory markers and lipids in the CHD group.the ACI group,the control group and all the cases. 4The area under receiver operator characteristic curve (AUC) of Lp-PLA2, hs-CRP and WBC were0.946,0.614,0.580in the ACI,all had certain diagnostic value to stroke especially the LP-PLA2.5The area under receiver operator characteristic curve (AUC) of Lp-PLA2、Mb、cTnI、 NT-proBNP、hs-CRP and WBC in CHD were0.922、0.630、0.607、0.617、0.542、0.540(>0.5),The area under receiver operator characteristic curve (AUC) of Lp-PLA2、Mb and cTnI in AMI were0.686、0.810、0.933,all indicators had certain diagnostic value at each phase of CHD.Conclusions:1The Lp-PLA2levels of the test groups were higher than that of controls, there’s no statistical significance between the Lp-PLA2levels of the CHD group and those of ACI group, prompted the diagnostic value of Lp-PLA2levels in the AS.2The Lp-PLA2levels not only had relationship with AS,but also the plate stability and the number of diseased vessels.the Lp-PLA2levels in unstable plaque or ruptured plaque were higher than that of stable plaque,and the more the vessels dissesed, the more the Lp-PLA2will be.3The increasing of Lp-PLA2levels was an independent risk factor in AS cardiovascular and cerebrovascular disease,it could be the early screening maker in AS,and be the clinical supplyment factor.4The Lp-PLA2had higher diagnostic value than other inflammatory markers and cardiac injured makers in AS.It could be the early indicator because of it’s high clinical value,but it could’t replace the cardiac injured makers in AMI.