血浆脂蛋白相关磷脂酶A2水平与颅内动脉粥样硬化斑块稳定风险的HR-MRI研究  

HR-MRI study of plasma lipoprotein-associated phospholipase A2 levels and the risk of intracranial atherosclerotic plaque stabilization

作　　者：严雪娇 高洁 张东升 张小玲[1] 汤敏[1] YAN Xue-jiao;GAO Jie;ZHANG Dong-sheng;ZHANG Xiao-ling;TANG Min(Department of Magnetic Resonance Imaging,Shanxi Provinical People′s Hospital,Xi′an 710068,China)

机构地区：[1]陕西省人民医院MRI室,陕西西安710068

出　　处：《河北医科大学学报》2022年第12期1468-1473,共6页Journal of Hebei Medical University

基　　金：国家自然科学基金面上项目(8217032354);陕西省重点研发计划重点项目(2018ZDXM-SF-038);陕西省重点研发计划一般项目(2021SF-064)。

摘　　要：目的评估血浆脂蛋白相关磷脂酶A 2(lipoprotein-associated phospholipase A 2,Lp-PLA 2)浓度水平与颅内斑块稳定特征之间的关系。方法回顾性纳入急性缺血性卒中患者83例。测定所有患者血浆Lp-PLA 2浓度水平。利用高分辨率磁共振成像(high resolution magnetic resonance imaging,HR-MRI)测定颅内血管的狭窄率及斑块稳定特征,包括斑块强化、斑块表面是否规则及斑块内T 1WI高信号;构建二分类Logistic回归模型,调整人口学及相关血脂混杂因素,评估高Lp-PLA 2浓度水平与颅内斑块稳定特征之间的关系。结果高Lp-PLA 2水平组患者中总胆固醇(total cholesterol,TC)、低密度脂蛋白(low density lipoprotein,LDL)及血脂异常差异有统计学意义(P<0.05)。在调整人口学及相关血脂因素后,Lp-PLA 2浓度水平升高与斑块强化(P=0.005,OR=21.347,95%CI:2.645~177.604)和斑块表面不规则(P=0.044,OR=3.008,95%CI:1.030~8.780)独立相关。结论Lp-PLA 2浓度水平升高与颅内斑块稳定性相关。Objective To evaluate the relationship between plasma lipoprotein-associated phospholipase A 2(Lp-PLA 2)concentration and characteristics of intracranial atherosclerotic plaque stability.Methods Eighty-three patients with acute ischemic stroke(AIS)were retrospectively enrolled.Plasma Lp-PLA 2 concentration was determined in all patients.High resolution magnetic resonance imaging(HR-MRI)was used to determine the stenosis rate of intracranial vessels and plaque stability characteristics,including plaque enhancement,regularity of the plaque surface and T 1WI hyperintensity in the plaque.A binary Logistic regression model was established to evaluate the relationship between high LP-PLA 2 concentration and characteristics of intracranial plaque stability by adjusting for demographic and related lipid confounders.Results There were significant differences in total cholesterol(TC),low density lipoprotein(LDL)and dyslipidemia in patients with high Lp-PLA 2 level.After adjustment for demographic and related lipid factors,increased Lp-PLA 2 concentration was independently associated with plaque enhancement(P=0.005,OR=21.347,95%CI 2.645-177.604)and plaque surface irregularity(P=0.044,OR=3.008,95%CI 1.030-8.780).Conclusion Increased Lp-PLA 2 concentration is associated with intracranial plaque stability.

关 键 词：斑块 动脉粥样硬化 核磁共振成像 血浆脂蛋白相关磷脂酶A 2 

分 类 号：R446.8[医药卫生—诊断学]