Study On The Effect Of Platelet Endothelial Cell Adhesion Molecule-1 Combined With Serum Lipoprotein-Associated Phospholipase A2 On The Stability Of Plaque

Objective This study intends to explore the role of platelet endothelial cell adhesion molecule-1(PECAMl/CD31)combined with serum lipoproteinassociated phospholipase A2(Lp-PLA2)in evaluating the stability of carotid atherosclerotic plaque.Methods 139 patients with carotid atherosclerosis plaque admitted to the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University from October 2017 to March 2019 were selected as research objects.Based on the results of CEUS,they were divided into unstable plaque group(76cases)and stable plaque group(63 cases).The gender,age,body mass index(BMI),smoking,drinking,hypertension and atrial fibrillation of the two groups were recorded.The fasting plasma glucose(FPG),white blood count(WBC),red blood count(RBC),neutrophil count,platelet,creatinine,uric acid,fibrinogen,high sensitivity C-reactive protein(hs-CRP),total cholesterol,triacylglycerol,high density lipoprotein,low density lipoprotein,the level of PECAM-1/CD31 and Lp-PLA2 were detected.The independent risk factors affecting the stability of carotid atherosclerotic plaque were screened out by multivariate Logistics regression analysis,and the ROC curve of each indicator was established to evaluate the effect of each indicator and joint indicators on carotid atherosclerotic plaque.Results The levels of smoking,atrial fibrillation,high-sensitivity C-reactive protein,total cholesterol,triacylglycerol,high-density lipoprotein,low-density lipoprotein,PECAM-1/CD31,and Lp-PLA2 were higher in the unstable plaque group than in the stable plaque group(P <0.05).Multivariate Logistic regression analysis showed that low-density lipoprotein [OR = 2.453,95% CI(2.322,2.591)],PECAM-1 / CD31 [OR = 1.372,95% CI(1.166,1.614)],and Lp-PLA2 [OR = 1.827,95% CI(1.565,2.133)] was an influential factor for the occurrence of carotid unstable plaques(P <0.05).PECAM-1 / CD31(r =0.090,P = 0.031)and Lp-PLA2(r = 0.090,P = 0.005)were significantly positively correlated with low density lipoprotein.The area under the ROC curve(AUC)of PECAM-1 / CD31 for diagnosis of carotid plaque stability was0.686,95% CI was(0.224,0.405),the best diagnosis point was 11.050 mg / L,the sensitivity was 77.60%,and the specificity 60.30%;AUC of Lp-PLA2 is0.724,95% CI is(0.189,0.364),the best diagnosis point is 176.585 mg / L,its sensitivity is 98.70%,and specificity is 47.60%;and the two diagnose the neck in combination The arterial unstable plaque had an AUC of 0.875,a 95% CI of(0.112,0.254),an optimal diagnosis point of 125.28 mg / L,a sensitivity of89.50%,and a specificity of 83.20%.Conclusions PECAM-1/CD31 and Lp-PLA2 have certain effect on the evaluation of unstable plaque of carotid atherosclerosise.The combination of PECAM-1 / CD31 and Lp-PLA2 can determine the instability of carotid plaque.The AUC of diagnostic performance is 0.875.