Correlation Of Lipoprotein Associated Phospholipase A2 With Transient Ischemic Attack Of Internal Carotid Artery System And Carotid Plaque

BackgroundTransient ischemic attack(TIA)is a symptom of neurological deficit caused by insufficient blood supply of internal carotid artery or vertebrobasilar artery,which accounts for about 32% of all strokes.The symptoms of this type of stroke are not obvious and there is no responsible focus on imaging,which is often ignored by patients and their families.However studies show that 4%-6% of TIA patients can relapse or progress in a short time.Therefore,the early identification of TIA and the intervention of risk factors are of great significance to the disease.Carotid atherosclerotic plaque formation is the main cause of ischemic stroke and inflammatory reaction is an important process of atherosclerotic plaque formation.Lipoprotein associated phospholipase A2(Lp-PLA2)is an inflammatory factor secreted by macrophages and lymphocytes,which can participate in the formation of atherosclerotic plaques and is considered as an important predictor of cardiovascular and cerebrovascular disease risk.ObjectiveTo investigate the relationship between lipoprotein associated phospholipase A2(Lp-PLA2)and transient ischemic attack of internal carotid artery system(TIA)and carotid plaques.To analyze the influencing factors of transient ischemic attack of internal carotid artery system and carotid plaque formation.MethodsA total of 160 patients with transient ischemic attack of internal carotid artery system admitted to Xinxiang Central Hospital from October 2020 to June 2022 as the study group and 80 healthy people in the same period as the control group.The study group was divided into the plaque free group(43 cases)and the plaque group(117 cases)according to the carotid intima-media thickness(IMT)shown by color ultrasound.The difference of serum Lp-PLA2 levels between the two groups was compared by independent sample t-test.Logistic regression was used to analyze the risk factors of TIA and carotid plaque formation.The diagnostic efficacy of serum Lp-PLA2 for TIA and carotid plaque was evaluated by receiver operating characteristic curue(ROC).Results(1)There were statistically significant differences in the levels of serum Lp-PLA2,TC,TG,LDL and the number of hypertensive patients between TIA patients with the control group,(both P<0.05).There were no statistically significant differences in age,sex,smoking,drinking,number of diabetes,HDL and BMI between TIA group and control group(both P>0.05).(2)Logistic regression analysis showed that TG,LDL,Hcy and Lp-PLA2 were the risk factors of TIA of internal carotid artery system.TC,Hcy and Lp-PLA2 are risk factors for carotid plaque formation in patients with TIA of internal carotid artery system.(3)The area under the curve of serum Lp-PLA2 level for diagnosis of TIA of internal carotid artery system was 0.938 and the optimal diagnostic threshold was131.75ng/m L.While the sensitivity was 83.75% and the specificity was 91.25%.The area under the curve of serum Lp-PLA2 level in the diagnosis of carotid plaques was 0.862 and the optimal diagnostic threshold was 168.5mg/l.While the sensitivity was 88.03%,and the specificity was 65.12%.ConclusionsSerum Lp-PLA2 level in TIA of internal carotid artery system patients increased,and serum Lp-PLA2 is one of the possible clinical markers of transient ischemic attack of internal carotid artery system and carotid plaque formation.Elevated levels of blood lipid,HCY and Lp-PLA2 are risk factors for TIA of internal carotid artery system and carotid plaque formation.Serum Lp-PLA2 is helpful to the diagnosis of TIA of internal carotid artery system and carotid plaque.