颈动脉粥样硬化斑块状态及性质与溶血磷脂酸及磷脂水平的关系

摘要

Objective To study the relations between the status and feature of carotid atherosclerosis plaque and the levels of lysophosphatidic acid(LPA) and phospholipids (AP), and investigate the function of LPA and AP in prewarning stroke. Methods 75 headache and dizziness patients with atherosclerotic carotid artery plaque showed by carotid artery ultrasound,had head CT / MRI,transcranial Doppler examinations and the determination of LPA and AP concentration. All patients were devided into different groups based on the location, size, number and nature of the plaque. 41 healthy volunteers served as control group. The levels of LPA and AP were compared in different groups.Results ①The most common location of the plaque was carotid artery enlargement, the second was the proximal internal carotid artery,the trunk of the carotid artery was few in control. But there was no significant difference between the locations and the levels of LPA and AP,LPA value:(4.09± 1.65) μmol/L vs (4.33± 1.70) μmol/L vs (4. 86±1.85) μmol/L ( P ＞0. 05) ;AP value(7. 51±3.02) μmol/L vs (7.71±2.64) μmol/L vs (8. 953.29) μmol/L( P ＞0.05). ②The levels of LPA and AP in large plaque groups were higher than those of small plaque group, LPA value (5.01 ±1.76) μmol/L vs (3.32 ± 1.44 ) μmol/L ( P ＜ 0.05 ). ③ The groups based on plaque number showed that single plaque was 49 cases, complex plaque was 26 cases, there was no significant difference between the plaque numbers and the levels of LPA value (4. 17±1.72) μmol/L vs (4.39± 1.76) μmol/L( P ＞0. 05),AP value(8. 13±3.63) μmol/L vs (7.8713.05) μmol/L( P ＞0.05). ④There were significant difference in the levels of LPA and AP in soft plaque groups and hard plaque groups compared with those of control group, LPA value (4. 30±1.79) μmol/L,(4. 27±1.69) μmol/L vs (2. 85/0. 86) μmol/L( P ＜0. 01) ;AP value (7. 97±3.77) μmol/L, (8. 02± 2. 70) μmol/L vs (5.02 ± 1.59) μmol/L( P ＜0.01). Conclusion The levels of LPA and AP have close relation to the status and nature of carotid atherosclerotic plaque. More attention should be given to LPA and AP in prewarning stroke.%目的 探讨颈动脉粥样硬化斑块状态及性质与溶血磷脂酸(LPA)及磷脂(AP)水平的关系,从而揭示LPA及AP对缺血性脑血管病的早期预警作用.方法 对75例颈动脉超声提示存在颈动脉粥样硬化斑块的头痛头晕者,行颅脑CT/MRI、经颅多普勒检查(TCD)及LPA和AP测定,按斑块位置、大小、数目3种状态及斑块性质进行分组.并选41例健康体检者作为对照组,比较不同组间的LPA和AP水平.结果 ①斑块最常发部位是颈动脉膨大处,其次是颈内动脉起始部,颈总动脉干部相对较少.按斑块位置分组,颈动脉膨大斑块组、颈总动脉斑块组和颈内动脉起始部斑块组间LPA和AP水平差异无统计学意义,LPA(4.09±1.65)μmol/L vs(4.33±1.70)μmol/L vs(4.86±1.85)μmol/1(P＞0.05);AP(7.51±3.02)μmol/L vs(7.71±2.64)μmol/L vs(8.95±3.29)μmol/1(P＞0.05).②大斑块组LPA水平较小斑块组增高明显,LPA(5.01±1.76)μmol/L vs(3.32±1.44)μmol/L(P＜0.05).③按斑块的数量分组显示单发斑块49例,多发斑块26例.单发斑块组与多发斑块组LPA和AP水平差异无统计学意义,LPA(4.17±1.72)μmol/L vs(4.39±1.76)μmol/L(P＞0.05);AP(8.13±3.63)μmol/L vs(7.87±3.05)μmol/1(P＞0.05).④软斑组及硬斑组与对照组间LPA、AP比较差异有统计学意义,LPA(4.30±1.79)μmol/L、(4.27±1.69)μmol/Lvs(2.85±0.86)μmol/L(P＜0.01);AP(7.97±3.77)μmol/L、(8.02±2.70)μmol/L vs(5.02±1.59)μmol/L(P＜0.01).结论 LPA和AP水平与颈动脉硬化斑块的状态及性质关系较大,应给予临床关注,警惕卒中发生的可能.