不同类型脑白质疏松与颈动脉粥样硬化斑块稳定性和血清脂蛋白相关磷脂酶A2的相关性  

Relationship Between Different Kinds of Leukoaraiosis,Stability of Carotid Atherosclerosis Plaque and Serum Lp-PLA2

作　　者：朱玉萍[1] 赵晓晖[1] 周媛[1] 江泉[2] 隋海晶[3] 沈健[1] 

机构地区：[1]上海市浦东新区人民医院神经内科,上海市201200 [2]上海市浦东新区人民医院超声科,上海市201200 [3]上海市浦东新区人民医院影像科,上海市201200

出　　处：《中国动脉硬化杂志》2014年第7期706-710,共5页Chinese Journal of Arteriosclerosis

基　　金：上海市卫生局基金项目(2007124);上海市浦东新区科技发展基金创新资金(PKJ2007-Y17)

摘　　要：目的探讨不同类型脑白质疏松(LA)患者颈动脉粥样硬化斑块稳定性及其与血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平的关系。方法将入组的LA患者根据头颅MRI表现分为脑室周围型组、皮质下型组和混合型组。应用颈动脉彩超检测颈动脉粥样硬化斑块并分为稳定性和不稳定性斑块,计算斑块积分。采用酸水解底物显色法测定血清Lp-PLA2水平。结果三组患者在年龄、性别、血压、血糖、低密度脂蛋白和血尿酸水平方面差异无统计学意义(P>0.05);皮质下型组和混合型组斑块阳性率、不稳定性斑块积分较脑室周围型组显著增高(P<0.01);三组血清Lp-PLA2水平两两相比均有显著性差异(P<0.05),皮质下型组血清Lp-PLA2水平最高,脑室周围型组血清Lp-PLA2水平最低,皮质下型组血清Lp-PLA2水平与不稳定性斑块积分呈正相关(r=0.270,P<0.05)。结论血清Lp-PLA2与颈动脉粥样硬化斑块的不稳定性存在一定的相关性,并通过炎症机制导致斑块破裂,在皮质下型LA的发生、发展中起重要作用。Aim To investigate the relativity of different kinds of leukoaraiosis（LA）,stability of carotid atherosclerosis plaque and serum Lp-PLA2. Methods All LA patients were divided into three groups according to their brain MRI： periventricular type group,subcortical type group and mixed type group. Carotid atherosclerosis plaques were detected by carotid artery ultrasonography and divided into stable palques and vulnerable plaques by their ultrasonographic images. Plaque score was calculated with crouses method. Serum Lp-PLA2 concentration was detected by acid hydrolysis of the substrate color method. Results Among the three groups,there were no statistically significant differences in the items including age,gender,blood pressure,glucose,low density lipoprotein and uric acid. The positive rates of carotid atherosclerosis plaque of subcortical type group and mixed type group were both absolutely higher than those of periventricular type group（ P 〈 0. 01）. There were marked difference of serum Lp-PLA2 concentration between each group（P 〈 0. 05）. Serum Lp-PLA2 concentration of subcortical type group was the highest and serum Lp-PLA2 concentration of periventricular type group was the lowest. Serum Lp-PLA2 concentration of subcortical type group was postively corelated to the scores of their vulnerable plaque（r = 0. 270,P 〈 0. 05）. Conclusions Serum Lp-PLA2 may be related to instability of carotid atherosclerosis plaque and can cause plaque rupture through imflammatory mechanisms,which plays an importment role in the process of occurence and development of LA of subcortical type group.

关 键 词：脑白质疏松 颈动脉粥样硬化斑块 脂蛋白相关磷脂酶A2 

分 类 号：R741[医药卫生—神经病学与精神病学]