Evaluation Of Carotid Plaque Stability In Patient With Cerebral Infarction By Plasma Lp-PLA2 Level Combined With Neovascularization Classification In Plaque

Objective: To evaluate the stability of carotid artery plaques in patients with arteriosclerotic cerebral infarction by plasma Lp-PLA2 level combined with contrast-enhanced ultrasound,and to identify a simple and feasible predictor of plaque stability.Methods:A total of 95 patients who had Anterior circulation ischemic symptoms and carotid artery hypoechoic plaques were enrolled.51 cases of newly diagnosed cerebral infarction were confirmed by cranial MRI in group ACI.The 44 patients had no new onset of cerebral infarction in non ACI group.Plasma Lp-PLA2 levels were measured by immunoturbidimetry in all patients.Ultrasound examination was used to evaluate the classification of neovascularization in the plaque.Results:1.There was no significant difference in age,sex,blood homocysteine,blood lipid and white blood cell count in two groups(P > 0.05).2.The grade I,II,III and IV plaques in group ACI accounted for11.8%,15.7%,39.2% and 33.3% of the group respectively.The grade I,II,III and IV plaques in the non ACI group accounted for 25%,38.6%,18.2%and 18.2% of the group respectively.The classification of neovascu larization in carotid artery plaque in group ACI was significantly higher than that in non ACI group,and the difference was statistically significant(Z=8.948,P=0.003).The grade of neovascularization in group ACI is mainly III and IV,and the non ACI group is mainly I and II.The proportion of them is 72.5% and 63.6%,respectively.The median level is III level and II level respectively.3.Plasma Lp-PLA2 levels in group ACI and non ACI group were268.647�121.244 ng/ml,220.341�106.336 ng/ml,respectively,and the difference was statistically significant(t=2.049,P=0.043).4.Analysis using ROC curve,the level of plasma Lp-PLA2 cutoff value was 185.5 ng/ml,the sensitivity in determining plaque stability:66.7%,specificity: 50%,the diagnostic accuracy was 62.30%.5.Between the plaque neovascularization grading and plasma levels of Lp-PLA2 the weak correlation(rs=0.22,P=0.046 < 0.05)Conclusion:1.Contrast-enhanced Ultrasound can determine the classification of neovascularization of carotid atherosclerotic plaques.2.The classification of neovascularization in the plaque can be used as a new index to evaluate the stability of plaque.3.Plasma Lp-PLA2 level combined with the classification of neovascularization in plaque can improve the predictive value of plaque instability.