血清脂蛋白相关磷脂酶A2水平对颈动脉粥样硬化斑块及其稳定性预测价值的研究  

Association between Serum Lipoprotein-associated Phospholipase A2 Level and Carotid Plaque Development and Vulnerability: a Cross-sectional Study

作　　者：申园[1] 王丹丹[1] 赵性泉[1] SHEN Yuan;WANG Dan-Dan;ZHAO Xing-Quan(Department of Neurology,Beijing Tian Tan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院神经病学中心国家神经系统疾病临床医学研究中心

出　　处：《中国卒中杂志》2019年第9期882-888,共7页Chinese Journal of Stroke

基　　金：脑出血损伤机制与干预评价研究（2018YFC1312200）;北京市医院管理局“登峰”人才培养计划（DFL20150501）;神经系统重大疾病创新药物临床评价技术平台建设（2017ZX09304018）

摘　　要：目的研究血清脂蛋白相关磷脂酶A2(1ipoprotein-associated phospholipase A2,Lp-PLA2)水平对颈动脉粥样硬化斑块及其稳定性的预测价值。方法本研究患者来源于无症状性多血管床狭窄的社区研究(AsymptomaticPolyvascular Abnormalities Community,APAC)。检测入组患者血清Lp-PLA2水平,通过超声评估颈动脉粥样硬化斑块特点。按照血清Lp-PLA2水平的四分位数,将受试者分为4组,用Logistic回归模型分析血清Lp-PLA2水平与颈动脉粥样硬化斑块及斑块稳定性的关系。结果高Lp-PLA2水平(>159.1 ng/mL)是颈动脉不稳定斑块发生的预测因素(OR 2.8,95%CI2.0~3.8,P<0.0001),在校正危险因素后,这种趋势没有发生变化(OR 1.7,95%CI 1.2~2.5,P=0.0067),在<60岁受试者中,该差异仍然存在(OR 1.7,95%CI 1.1~2.7,P=0.0142),但在≥60岁受试者中,其预测价值未达到统计学意义。结论较高血清Lp-PLA2水平是颈动脉不稳定粥样硬化斑块发生的预测因素,尤其在<60岁患者中。Objective To investigate the association of serum total 1ipoprotein-associated phospholipase A2(Lp-PLA2)level with the vulnerability of atherosclerotic carotid plaques.Methods Data of this cohort study were from Asymptomatic Polyvascular Abnormalities Community(APAC)study,which was a cross-sectional study.The data of serum Lp-PLA2 level and ultrasonographic assessment of carotid plaques were extracted and analyzed.The participants were divided into 4 groups based on the quartile of serum total Lp-PLA2 level.The multivariate logistic regression analysis was used to analyze the correlation between the serum total Lp-PLA2 level and carotid plaque development and vulnerability.Results A high Lp-PLA2 level(>159.1 ng/mL)was associated with carotid plaque vulnerability amongst the adults(OR 2.8,95%CI 2.0-3.8,P<0.0001).After adjusting for the relevant risk factors,the tendency still existed(OR 1.7,95%CI 1.2-2.5,P=0.0067).For subjects aged<60 years old,the correlation between the two variates still existed(OR 1.7,95%CI 1.1-2.7,P=0.0142),while for subjects aged≥60 years old,the difference of serum Lp-PLA2 level among the 4 groups had no statistical significance Conclusions An elevated serum Lp-PLA2 level was associated with carotid plaque vulnerability in adults,especially ones aged<60 years.

关 键 词：脂蛋白相关磷脂酶A2 颈动脉 动脉粥样硬化斑块 危险因素 

分 类 号：R54[医药卫生—心血管疾病]