The Study On The Changes Of Serum Lipoprotein-related Phospholipase A2 And Carotid Atherosclerotic Plaque In Patients With White Matter Lesion Based On KIM

Objective To explore the relationship between serum lipoprotein-associated phospholipase A2(LP-PLA2)and KIM-based white matter lesion(WML)and carotid atherosclerotic plaque.Methods From November 2018 to July 2019,125 WML patients admitted to the Department of Neurology of the First Affiliated Hospital of Anhui Medical University were enrolled as WML group.30 cases with normal MRI,matching age and gender of the same period were selected as the control group(NC group).According to KIM classification,WML patients were divided into JVWML group(n=30),PVWML group(n=33),JCWML group(n=30),DWML group(n=32).Investigate and document the clinical data of vascular risk factors in all subjects;Determination of serum Lp-PLA2 content in all subjects by double antibody sandwich enzyme-linked immunosorbent assay(ELISA);Carotid atherosclerosis plaques were detected by cartid artery ultrasonography and divided into stable plaques and vulnerable plaques,and calculate the total score of each plaque according to the Crouse method.Using SPSS 22.0 statistical software analysis,the threshold value is P<0.05.Results The proportion of hypertension,Hcy,LP-PLA2,stable plaque score and vulnerable plaque score in WML group were significantly higher than those in NC group(both P<0.05).The levels of serum LP-PLA2 in PVWML and DWML groups were significantly higher than that of NC group(both P<0.01).Compared with NC group,the Hcy was significantly increased in PVWML group and DWML group;The proportion of hypertension in the JCWML group and the DWML group was higher than that in the NC group(both P<0.05);The stable plaque scores of the four groups of WML patients were significantly higher than those of the NC group(both P<0.05);The vulnerable plaque score in the PVWML group was significantly higher than that in the NC group(P<0.05).The level of hs-CRP in the PVWML group was significantly higher than that in the JVWML group,JCWML group,and DWML group(P<0.05,P<0.01,P<0.05);The level of serum LP-PLA2 in PVWML group was significantly higher than that in JVWML group and JCWML group(both P<0.01);The level of serum LP-PLA2 in DWML group was significantly higher than that in JCWML group(P<0.01);There were no significant differences in stable plaque scores and vulnerable plaque scores between the four groups of WML patients(both P>0.05).Correlation analysis revealed age(r=0.411,P=0.024),alcohol consumption(r=0.496,P=0.005),Hcy(r=0.461,P=0.010)in JVWML group were positively correlated with vulnerable plaque scores;blood glucose(r=0.600,P=0.000),TG(r=0.371,P=0.034),LDL-C(r=0.367,P=0.036),LP-PLA2(r=0.567,P=0.001)were positively correlated with vulnerable plaque scores in PVWML group,while,it is negatively correlated with HDL-C(r=-0.368,P=0.035).Multivariate linear regression of blood glucose,TG,LDL-C,LP-PLA2,HDL-C and vulnerable plaque scores in PVWML group showed no significant correlation between TG,LDL-C,HDL-C and vulnerable plaque scores(both P>0.05),blood glucose(b=0.463,P<0.01)and LP-PLA2(b=0.347,P<0.05)were still positively correlated with vulnerable plaque scores.Conclusion Serum LP-PLA2 is an indicator of atherosclerosis,which is associated with carotid instability plaques in periventricular white matter lesions,suggesting that inflammatory mechanisms play an important role in the development of ischemic white matter lesions,detection of LP-PLA2 is of certain value for early identification of white matter lesions.