IMT联合血清Lp-PLA2在诊断动脉粥样硬化脑梗死与预测斑块稳定性的价值  

Value of IMF combined with serum Lp-PLA2 in diagnosis of atherosclerotic cerebral infarction and prediction of plaque stability

作　　者：何丹青[1] 邱文倩[1] 牛居辉 HE Danqing;QIU Wenqian;NIU Juhui(Department of ultrasound,the first affiliated hospital of anhui medical university,Hefei,Anhui,China,230000;Department of anesthesiology,the first people's hospital of wuhu city,Wuhu,Anhui,China,241000)

机构地区：[1]安徽医科大学第一附属医院超声科,安徽合肥230000 [2]芜湖市第一人民医院麻醉科,安徽芜湖241000

出　　处：《分子诊断与治疗杂志》2020年第6期790-793,共4页Journal of Molecular Diagnostics and Therapy

基　　金：芜湖市科技计划项目(2016hm15)。

摘　　要：目的探究颈动脉内中膜厚度(IMT)联合血清脂蛋白相关磷脂酶A2(Lp-PLA2)在诊断动脉粥样硬化脑梗死与预测斑块稳定性的价值。方法选取本院2017年1月至2019年10月动脉粥样硬化脑梗死患者117例作为研究组,另选取同期健康体检者112例作为对照组。均进行颈动脉超声检查、血清Lp-PLA2检测,比较两组颈动脉内中膜厚度(IMT)、血清Lp-PLA2水平,采用受试者工作(ROC)曲线探究IMT、血清Lp-PLA2诊断动脉粥样硬化脑梗死的价值,对比不同稳定性斑块患者IMT、血清Lp-PLA2水平,探究二者之间关系及与斑块稳定性的相关性。结果研究组IMT、血清Lp-PLA2高于对照组,差异有统计学意义(P<0.05);IMT、血清Lp-PLA2联合诊断动脉粥样硬化脑梗死的曲线下面积(AUC)为0.889,大于二者单独诊断,联合诊断的最佳敏感度为76.07%,特异度为90.18%;不稳定斑块患者IMT、血清Lp-PLA2水平>稳定斑块患者>无斑块患者,差异有统计学意义(P<0.05);动脉粥样硬化脑梗死患者的斑块稳定性与IMT、血清Lp-PLA2水平显著相关,差异有统计学意义(P<0.05)。结论 IMT及血清Lp-PLA2表达有助于动脉粥样硬化脑梗死的诊断,且是颈动脉不稳定粥样硬化斑块发生的预测因素,可为临床诊断动脉粥样硬化脑梗死患者及制定治疗方案提供重要参考依据。Objective To explore the value of carotid intima-media thickness(IMT)combined with serum lipoprotein-associated phospholipase A2(Lp-PLA2)in the diagnosis of atherosclerotic cerebral infarction and the prediction of plaque stability.Methods A total of 117 patients with atherosclerotic cerebral infarction from January 2017 to October 2019 in our hospital were selected as the research group,and 112 healthy patients during the same period were selected as the control group.Carotid artery ultrasound examination and serum Lp-PLA2 detection were performed to compare the carotid intima-media thickness(IMT)and serum Lp-PLA2 levels of the two groups.The receiver operating characteristic(ROC)curve was used to explore the value of IMT and serum Lp-PLA2 in the diagnosis of atherosclerotic cerebral infarction,the levels of IMT and serum Lp-PLA2 in patients with different stable plaques were compared,and the relationship between them and their correlation with plaque stability were explored.Results The IMT and serum Lp-PLA2 in the research group were higher than those in the control group,the difference was statistically significant(P<0.05).The area under the curve(AUC)of the combined diagnosis of IMT and serum Lp-PLA2 for the diagnosis of atherosclerotic cerebral infarction was 0.889,which was larger than the two diagnosed alone,the optimal sensitivity of the combined diagnosis was 76.07%,and the specificity was 90.18%;IMT and serum Lp-PLA2 levels in patients with unstable plaque>patients with stable plaque>patients without plaque,the difference was statistically significant(P<0.05).The plaque stability of patients with atherosclerotic cerebral infarction was significantly correlated with IMT and serum Lp-PLA2 levels(P<0.05).Conclusion IMT and serum Lp-PLA2 expression are helpful for the diagnosis of atherosclerotic cerebral infarction,and are predictive factors for the occurrence of unstable carotid atherosclerotic plaques,which can provide an important reference for the clinical diagnosis of patients with atherosclerotic cer

关 键 词：动脉粥样硬化脑梗死 颈动脉超声 颈动脉内中膜厚度 脂蛋白相关磷脂酶A2 诊断 斑块稳定性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]