颈动脉狭窄患者术前外周血Lp-PLA2和sPLA2水平变化及其临床意义  

Clinical Study of Carotid Artery Stenosis in Patients with Preoperative Peripheral Blood Lp-PLA2 and s PLA2 Level Change

作　　者：刘晓佳[1] 伍健明[1] 张猛[1] 何毅[1] 张协军[1] 

机构地区：[1]深圳市第二人民医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2016年第21期1-3,F0003,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：深圳市科技计划项目资助课题(JCYJ20140414170821291)

摘　　要：目的:研究颈动脉狭窄患者术前外周血中血浆脂蛋白相关磷酯酶A2(LP-PLA2)和分泌型磷酯酶A2(s PLA2)水平变化,分析其与颈动脉内膜剥脱术(CEA)后留取粥样硬化斑块组织标本稳定性及斑块内炎症活跃程度之间的相关性。方法:收集深圳市第二人民医院40例行颈动脉内膜剥脱术的患者为观察组,同期筛查结果提示健康者32例正常对照组,收集对照组患者的外周血,观察组患者术前的外周血及手术留取粥样硬化斑块组织,采用双抗体夹心酶联免疫吸附法测定血清LPPLA2和s PLA2水平,病理学检查分析粥样硬化斑块组织标本的CD3和CD68阳性表达情况。分析LP-PLA2和s PLA2水平与斑块稳定性及斑块内炎症反应活跃程度的相关性。结果:CEA术前患者外周血中LP-PLA2及s PLA2的水平高于正常对照组,斑块易损组Lp-PLA2及s PLA2水平明显高于斑块稳定组(P<0.01)。LP-PLA2及s PLA2的活性与斑块内炎症反应活跃程度呈正相关。结论:外周血中Lp-PLA2和s PLA2水平与病理学数据支持的斑块稳定性呈正相关,可作为评价颈动脉斑块稳定性及炎症反应活跃程度的指标。Objective To study the Lp-PLA2 and s PLA2 level change of carotid artery stenosis in patients with preoperative peripheral blood, and analyze the correlation between atherosclerotic plaque tissue specimens and plaque stability in infl ammatory activity after the operation of carotid endarterectomy（CEA）. Method 40 cases of carotid artery stenosis who underwent CEA surgery preoperative peripheral blood and surgical left atherosclerotic plaque tissue were collected, and double antibody sandwich enzyme linked immunosorbent assay（ELISA） was used to determine of serum levels of Lp-PLA2 and s PLA2. Pathological examination analysis of atherosclerotic plaque tissue specimens of the stability and the level of infl ammatory reaction（CD68 and CD3）,and controlled to 32 cases underwent health screening. And the correlation between the levels of LP-PLA2 and s PLA2 and the stability of plaque and the degree of active infl ammation in the plaque were analyzed. Results The levels of patient＇s peripheral blood of Lp-PLA2 and s PLA2 higher than the normal control group,the level of Lp-PLA2 and s PLA2 in vulnerable plaque group was signifi cantly higher than that of the stable plaque group（P 〈0.01）.Positive correlate with Lp-PLA2 and s PLA2 activity and plaque infl ammation active degree（CD3, CD68）. Conclusion The levels of Lp-PLA2 and s PLA2 in peripheral blood were positively correlated with the plaque stability, which can be used as an index for evaluating the stability of carotid plaque and the degree of active infl ammation.

关 键 词：颈动脉狭窄 血浆脂蛋白相关磷酯酶a2 分泌型磷酯酶a2 斑块稳定性 炎症反应 

分 类 号：R543.4[医药卫生—心血管疾病]