| Objective: With the improvement of living standards,human disease spectrum has undergone great changes.At present,cerebrovascular disease has become one of the major causes of disability and death in the world,seriously affecting people's lives and quality of life.The most common cause of cerebral infarction is atherosclerosis(Arteriosclerosis,AS),and the unstable state of atherosclerotic plaque is closely related to cerebral infarction.Cervical vascular plaque instability is more dangerous than cervical stenosis factor.Therefore,timely identification and treatment of unstable plaques in the neck may reduce the incidence of cerebral infarction.Therefore,it is particularly important to explore biomarkers that predict the stability of atherosclerotic plaques.Currently,Lipoprotein-associated phospholipase A2(Lp-PLA2) has been unanimously recommended by four international authoritative guidelines for the evaluation of moderate or high cardiovascular and cerebrovascular risk.This study was to determine the plasma lipoprotein-associated phospholipase A2 levels in patients with acute cerebral infarction(Acer),and to analyze the relationship between lipoprotein-associated phospholipase A2 and acute cerebral infarction and vascular plaque stability in the neck.Whether protein-related phospholipase A2 can be a clinical marker of vascular unstable plaque provides a theoretical basis for the prevention and treatment of cerebral infarction.Methods: One hundred patients with acute cerebral infarction who underwent hospitalization in the Department of Neurology,Second Hospital of Hebei Medical University from 2017 to September to 2019-01 were enrolled as cerebral infarction group.In the same period,the Department of Neurology in our hospital had a history of hypertension,no history of diabetes,and no CT confirmed by head CT/MRI.No plaque was confirmed by cervical vascular ultrasound.Other patients with no heart disease confirmed by echocardiography.50 cases served as a control group.The standard of cerebral infarction group:1.Age: 18-80 years old 2.Gender: male or female 3.in line with the 2010 edition of "China Acute Ischemic Stroke Diagnosis and Treatment Guidelines" diagnostic criteria for acute ischemic stroke,confirmed by head CT / MR with a clear infarct,and MRA prompted atherosclerosis.4.have a history of hypertension.As exclusion criteria:1.The pathogenesis of coronary heart disease,atrial fibrillation,valvular disease,congenital heart disease caused by cardiac cerebral embolism.2.Other special types of cerebrovascular diseases such as: congenital dysplasia,moyamoya disease,arteritis,aneurysm,infectious,immune,non-immune,hereditary vascular disease,hypercoagulable state,blood disease and drug abuse Acute cerebral infarction.3.have a history of diabetes.Exit or termination criteria in the cerebral infarction group:1.Secondary cerebral hemorrhage conversion during hospitalization,subdural/external hematoma,and subarachnoid hemorrhage.2.The patient or family member requests to withdraw from the test.According to the nature of cervical artery plaque,the components of cerebral infarction were stable plaque group and unstable plaque group.The two groups collected the general conditions of age,sex,smoking,drinking and blood biochemical indicators for comparative analysis.Plasma Lp-PLA2 levels were determined by double antibody sandwich immunochromatography(upconversion luminescence).The measured data were statistically processed using SPSS21.0.The measurement data was expressed by(x±s),which did not satisfy the normality,and was expressed by the median(quartile).The Mann-Whitney U test was used to compare the independent groups.The count data was expressed by n(%),and the chi-square analysis was used for comparison between groups;the difference was statistically significant at the test level P < 0.05.Results:1.Comparison of general factors between case group and control group There was no significant difference in gender,age,proportion of drinkers,and proportion of smokers between the case group and the control group by t test or 2 test(P>0.05).2.Plasma Lp-PLA2 level distribution The distribution of plasma Lp-PLA2 was normally distributed with a mean value of 234.73 ng/ml,a standard deviation of 154.616,and a total of 150 cases.3.Comparison of biochemical indicators between case group and control group The serum total cholesterol,triglyceride and low density lipoprotein levels in the case group were significantly higher than those in the control group(P<0.05),and the difference was statistically significant.There was no significant difference in serum high-density lipoprotein levels between the patients in the case group.4.Comparison of plasma Lp-PLA2 levels between case group and control group The average plasma Lp-PLA2 level in the case group was 287 ng/ml,which was significantly higher than that in the control group.The mean Lp-PLA2 level was 79 ng/ml(P<0.001).The difference between the two groups was statistically significant.5.Comparison of plasma Lp-PLA2 levels between unstable plaque group and stable plaque group Plasma Lp-PLA2 levels were 376 ng/ml in the unstable plaque group and 165 ng/ml(P < 0.001)in the stable plaque group.The difference was statistically significant.Conclusion:Plasma Lp-PLA2 levels in patients with acute cerebral infarction were significantly higher than those in the control group;plasma Lp-PLA2 levels were significantly higher in patients with unstable vascular plaque in the neck than in the plaque stable group.The results suggest that plasma Lp-PLA2 levels are closely related to the occurrence of acute cerebral infarction and vascular plaque stability.Elevated plasma Lp-PLA2 levels are an important risk factor for acute cerebral infarction and can be used as a biomarker for predicting the risk of acute ischemic stroke,and plasma Lp-PLA2 levels can aid in the prediction of atherosclerotic plaque The degree of stability plays an important role in secondary prevention and individualized treatment of patients with acute cerebral infarction. |
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