CyPA、Lp-PLA2与颈动脉不稳定斑块及脑梗死的相关性研究

发布时间：2018-03-13 15:19

本文选题：颈动脉不稳定斑块　切入点：动脉粥样硬化脑梗死　出处：《石河子大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:动脉粥样硬化是脑梗死的病理基础,而不稳定斑块的形成是脑梗死发生、复发的关键因素,炎症反应参与动脉粥样硬化的发生发展及不稳定斑块形成、破裂的整个过程。本研究通过检测颈动脉硬化不稳定斑块伴动脉粥样硬化脑梗死(ACI)患者(ACI组)、颈动脉硬化不稳定斑块患者(单纯斑块组)及健康体检者(对照组)血清亲环素A(Cy PA)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平,探讨观察者血清Cy PA、Lp-PLA2水平与斑块不稳定性及ACI的关系。方法:选择2014年11月-2015年8月就诊于石河子大学医学院第一附属医院神经内科经颈动脉彩超检查确诊患有颈动脉粥样硬化不稳定斑块患者100例,依据是否发生脑梗死分为2个亚组:ACI组50例,单纯斑块组50例;以及同期健康体检者50例。所有入选患者记录性别、年龄、身高、体重、吸烟史,入院后第二日清晨空腹静脉血指标包括总胆固醇(Total cholesterol,TC),甘油三酯(Triglyceride,TG),高密度脂蛋白(Highdensitylipoproteincholesterol,HDL),低密度脂蛋白(Lowdensitylipoproteincholesterol,LDL)、糖化血红蛋白(Hb Alc)、血同型半胱氨酸(HCY)、C-反应蛋白(CPR)等。采用酶联免疫吸附法(ELISA)测定3组血清亲环素A及脂蛋白相关磷脂酶A2的水平。所有数据应用SPSS 17.0统计软件进行分析,计量资料以均数±标准差(x±S)表示,多组间均数的比较采用单因素方差分析,方差不齐着行秩和检验;计数资料以率(%)表示,行卡方检验;以脑梗死为因变量作logistic回归分析,进行脑梗死危险因素分析。结果:患者的血清CyPA水平为ACI组(2.031±0.679 ng/ml)斑块组(3.790±0.943 ng/ml)对照组(5.113±1.568 ng/ml),差异有统计学意义(P0.01)。logistic回归分析显示,Cy PA是颈动脉不稳定斑块患者发生脑梗死的独立危险因素(OR=2.71,95%CI:1.52~4.83,P=0.01)。以Cy PA、Lp-PLA2为双变量行相关分析显示,两者呈正相关,r(相关系数)=0.343。结论:血浆Cy PA、Lp-PLA2水平可作为颈动脉不稳定斑块的临床标记物;Cy PA可能是不稳定斑块患者发生脑梗死的独立危险因素;联合检测血清Cy PA、Lp-PLA2水平可能会预测ACI的发生。
[Abstract]:Objective: atherosclerosis is the pathological basis of cerebral infarction, and the formation of unstable plaque is the key factor of the occurrence and recurrence of cerebral infarction. Inflammatory reaction is involved in the occurrence and development of atherosclerosis and the formation of unstable plaque. The whole process of rupture. In this study, we detected the ACI group in patients with unstable carotid plaque with atherosclerotic cerebral infarction, the patients with unstable plaque in carotid artery (simple plaque group) and the control group (control group). ) the serum levels of cyclophile, lipoprotein associated phospholipase A _ 2, Lp-PLA2), To investigate the relationship between serum Cy PAA 2 Lp-PLA2 level and plaque instability and ACI. Methods: selected from November 2014 to August 2015 at the Department of Neurology affiliated to the first affiliated Hospital of Shihezi University Medical College diagnosed the patient with carotid color Doppler ultrasonography. 100 patients with unstable carotid atherosclerotic plaques, According to the occurrence of cerebral infarction, 50 patients were divided into two subgroups: ACI group (n = 50), plaque group (n = 50) and physical examination (n = 50). All patients were enrolled to record their sex, age, height, weight, smoking history. On the early morning of 2nd after admission, fasting venous blood parameters included Total cholesterol cholesterol total TCN, triglyceride-triglyceride-TGG, high density lipoprotein cholesterol cholesterol cholesterol, low density lipoprotein cholesterol cholesterol, glycosylated hemoglobin HbAlcc, serum homocysteine, HCYC- reactive protein, and so on. The enzyme linked immunosorbent assay (Elisa) was used for the determination of serum total cholesterol, triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride-triglyceride. The serum levels of cyclophile A and lipoprotein associated phospholipase A 2 were measured by Elisa. All the data were analyzed by SPSS 17.0 statistical software. The measurement data were expressed as mean 卤standard deviation (x 卤S). The multivariate mean was compared with single factor ANOVA, the variance was uneven and the rank sum test was performed; the counting data was expressed by chi-square test; and the logistic regression analysis was made with cerebral infarction as dependent variable. The risk factors of cerebral infarction were analyzed. Results: the serum CyPA level of the patients was 2.031 卤0.679 ng / ml in ACI group. The plaque group was 3.790 卤0.943 ng / ml) the control group was 5.113 卤1.568 ng / ml / ml. The difference was statistically significant (P 0.01). Logistic regression analysis showed that Cy PA was the cause of cerebral infarction in patients with unstable plaque of carotid artery. The independent risk factor for death was 2.71% and 95% CI: 1.52and 4.83% P0.01.The correlation analysis showed that Cy PAN Lp-PLA2 was used as a bivariate correlation analysis. Conclusion: plasma Cy PAP Lp-PLA2 level may be an independent risk factor for cerebral infarction in patients with unstable carotid plaque. Combined detection of serum Cy PAA 2 Lp-PLA2 may predict the occurrence of ACI.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R743.3

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