Objective:To investigate the predictive value of lipoprotein associated phospholipase A2 (Lp-PLA2) in carotid artery plaque vulnerability in patients with acute anterior circulation infarction.Methods:A total of 150 patients with acute anterior circulation infarction,who were treated in Jiangsu Province People's Hospital from September 2015 to March 2017,were selected as study group;Another 100 healthy people uundergoing physical examinations in this hospital were selected as control group at the same period.Serum Lp-PLA2 and hypersensitive C reactive protein (hs-CRP) levels were detected in the two groups.Color Doppler ultrasonography was used to examine the carotid atherosclerosis in the study group,the serum levels of Lp-PLA2,hs-CRP,and carotid intima-media thickness (IMT) were analyzed in the patients with different carotid atherosclerosis,and the predictive value of serum Lp-PLA2 for carotid artery plaque vulnerability was analyzed.Results:The serum levels of Lp-PLA2,hs-CRP and IMT in the study group were significantly higher than those in the control group (P＜0.05).The serum levels of Lp-PLA2,hs-CRP and IMT in vulnerable plaque group,stable plaque group and intimal thickening group were significantly higher than those of normal endometrium group;the serum levels of Lp-PLA2,hs-CRP and IMT in vulnerable plaque group and stable plaque group were significantly higher than those of intimal thickening group (P＜0.05);the serum levels of Lp-PLA2 and hs-CRP in the vulnerable plaque group were significantly higher than those in the stable plaque group (P＜0.05).There was no significant difference in IMT between the two groups (P＞0.05).The serum levels of Lp-PLA2,hs-CRP and IMT in the patients with cerebral infarction of severe and moderate group were significantly higher than those of mild group,and the serum levels of Lp-PLA2,hs-CRP and IMT in the severe group were significantly higher than those in the moderate group (P＜0.05).The ROC curve showed that the area under the curve (AUC) for predicting the vulnerability of carotid plaques in patients with cerebral infarction by serum Lp-PLA2 and hs-CRP was 0.809 (95％CI:0.739-0.883) and 0.598 (95％CI:0.495-0.694),respectively.The predictive value of serum Lp-PLA2 on carotid artery plaque vulnerability in the patients with cerebral infarction was significantly higher than that of hs-CRP (P＜0.05).Conclusion:The level of serum Lp-PLA2 is abnormally elevated in the patients with acute anterior circulation infarction,and its level can reflect the vulnerability of carotid artery plaque,which can provide the basis for the diagnosis of cerebral infarction.%目的:探讨脂蛋白相关磷脂酶A2(Lp-PLA2)对急性前循环脑梗死患者颈动脉斑块易损性的预测价值.方法:选取2015年9月至2017年3月我院收治的急性前循环脑梗死患者150例作为研究组,另选同期我院体检健康者100例作为对照组,检测两组血清Lp-PLA2、超敏C反应蛋白(hs-CRP)水平,并应用彩色多普勒超声检查研究组患者颈动脉粥样硬化情况,分析不同颈动脉粥样硬化情况以及不同病情患者血清Lp-PLA2、hs-CRP、颈动脉内膜-中层厚度(IMT),并分析血清Lp-PLA2对颈动脉斑块易损性的预测价值.结果:研究组血清Lp-PLA2、hs-CRP和IMT均显著高于对照组(P＜0.05).易损斑块组、稳定斑块组、内膜增厚组血清Lp-PLA2、hs-CRP和IMT均显著高于内膜正常组,易损斑块组、稳定斑块组血清Lp-PLA2、hs-CRP和IMT均显著高于内膜增厚组(P＜0.05),易损斑块组血清Lp-PLA2、hs-CRP显著高于稳定斑块组(P＜0.05),而IMT比较无统计学差异(P＞0.05).重度组、中度组脑梗死患者血清Lp-PLA2、hs-CRP和IMT均显著高于轻度组,重度组脑梗死患者血清Lp-PLA2、hs-CRP和IMT显著高于中度组(P＜0.05).ROC曲线显示血清Lp-PLA2、hs-CRP对脑梗死患者颈动脉斑块易损性预测的曲线下面积(AUC)分别为0.809(95％CI:0.739-0.883)、0.598(95％CI:0.495-0.694),血清Lp-PLA2对脑梗死患者颈动脉斑块易损性的预测价值显著高于hs-CRP(P＜0.05).结论:急性前循环脑梗死患者血清Lp-PLA2出现异常升高,其水平可以反映颈动脉斑块易损性,可为脑梗死诊断提供依据.
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