MHR、血浆Lp-PLA2对脑梗死患者颈动脉斑块不稳定性的预测价值  

Predictive Value of Ratio of Monocytes to HDL Cholesterol and Lipoprotein-associated Phospholipase A2 for Carotid Plaque Instability

作　　者：赵帅 赵鲜 李合华[1] 常利[1] 刘丽[1] 张建龙 韩英博 葛晓敏 Zhao Shuai;Zhao Xian;Li Hehua(The First Affiliated Hospital of Xinxiang University of Chinese Medicine,Xinxiang,Henan,450000,China;不详)

机构地区：[1]新乡医学院第一附属医院,河南新乡453100 [2]河南中医药大学,河南郑州450000

出　　处：《黑龙江医学》2024年第17期2084-2087,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨单核细胞与高密度脂蛋白胆固醇比值(MHR)、血浆脂蛋白相关磷脂酶A2(Lp-PLA2)对脑梗死患者颈动脉斑块不稳定性的预测价值。方法:回顾性分析2020年1月—2022年1月新乡医学院第一附属医院神经内科三病区收治的190例首次急性脑梗死患者的临床资料。所有患者均行超声检查,了解颈动脉斑块情况,并依据超声结果将其分为无斑块组50例、稳定性斑块组42例、不稳定性斑块组98例。采用全自动生化分析仪检测血常规、血脂、血浆Lp-PLA2等相关指标,比较三组患者的临床基线资料及各项指标,采用logistic回归分析评估颈动脉斑块形成及斑块不稳定性的独立危险因素。结果:无斑块组和斑块组患者年龄、吸烟、低密度脂蛋白胆固醇、高血压病、单核细胞计数、血浆Lp-PLA2、MHR比较,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,吸烟、低密度脂蛋白胆固醇、MHR是颈动脉斑块形成的独立危险因素。稳定斑块组和不稳定斑块组患者吸烟、低密度脂蛋白胆固醇、单核细胞计数、MHR、血浆Lp-PLA2比较,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,吸烟、MHR、血浆Lp-PLA2是颈动脉斑块不稳定性的独立危险因素。MHR预测颈动脉不稳定性斑块的ROC曲线分析结果显示,AUC=0.787,95%CI=0.707~0.866,P<0.05,敏感度为81.6%,特异度为61.9%;血浆Lp-PLA2预测颈动脉不稳定性斑块的受试者ROC曲线分析结果显示,AUC=0.768,95%CI=0.689~0.847,P<0.05,敏感度为79.6%,特异度为52.4%。结论:血浆Lp-PLA2及MHR是颈动脉斑块形成及斑块不稳定性的独立危险因素,对斑块的不稳定性具有较好的预测价值,对高水平的血浆Lp-PLA2及MHR尽早干预,能够减少因斑块破裂导致的脑梗死的发生率。Objective:To investigate the predictive value of monocytes to HDL lipoprotein cholesterol ratio(MHR)and plasma lipoprotein-associated phospholipase A2(Lp-PLA2)in carotid plaque instability in patients with cerebral infarction.Methods:A retrospective analysis method was used to include 190 patients with first acute cerebral infarction who were treated in the Third Ward of the Department of Neurology,the First Affiliated Hospital of Xinxiang Medical College from January 2020 to January 2022.All participants underwent ultrasonography to know the carotid artery plaque situation,and according to the ultrasound results,they were divided into plaque-free group(50 cases),stable plaque group(42 cases),and unstable plaque group(98 cases).The automatic biochemical analyzer was used to detect relevant indicators,such as blood routine,blood lipids,plasma Lp-PLA2.The clinical baseline data and various indicators of each group were compared and analyzed.The independent risk factors for carotid artery plaque formation and instability were assessed by binary multivariate logistic regression analysis.Results:Compared with the plaque group,there were significant differences in age,smoking,LDL cholesterol,hypertension,monocyte count,Lp-PLA2 and MHR(P<0.05).Logistic regression analysis showed that smoking,LDL cholesterol and MHR were independent risk factors for carotid plaque formation.Compared with the unstable plaque group,the differences in smoking,LDL cholesterol,monocytes,MHR,plasma Lp-PLA2 were statistically significant(P<0.05).Logistic regression analysis showed that smoking,MHR and Lp-PLA2 were independent risk factors for carotid plaque instability.ROC analysis results of MHR prediction of carotid unstable plaque showed that AUC=0.787,95%CI=0.707~0.866,P<0.05,sensitivity was 81.6%,and specificity was 61.9%.ROC curve analysis of Lp-PLA2 for predicting carotid unstable plaque showed that AUC=0.768,95%CI=0.689~0.847,P<0.05,sensitivity was 79.6%,and specificity was 52.4%.Conclusion:Lp-PLA2 and MHR are independent risk factors f

关 键 词：单核细胞与高密度脂蛋白胆固醇比值 血浆脂蛋白相关磷脂酶A2 颈动脉斑块 斑块不稳定性 

分 类 号：R543[医药卫生—心血管疾病]