Salusin-α、Lp-PLA2与颈动脉粥样硬化不稳定斑块及脑梗死之间的关系探讨

发布时间：2019-02-26 09:30

【摘要】：目的:颈动脉粥样硬化是导致脑梗死的主要原因,其形成机制非常复杂,得到共识的即脂质学说和炎症学说,本研究通过检测脂质因子salusin-α及炎症因子脂蛋白相关磷脂酶A2在健康体检者、颈动脉粥样硬化不稳定斑块患者及不稳定斑块并发脑梗死患者血清中的含量,探讨血清salusin-α及脂蛋白相关磷脂酶A2与颈动脉粥样硬化不稳定斑块患者并发脑梗死的相关性。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:脑梗死组50例,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,入院后第二日清晨血压、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salusin-α及脂蛋白相关磷脂酶A2水平。统计学方法采用SPSS 17.0软件进行统计学分析,计量资料以均数±标准差表示,多组间均数的比较采用单因素方差分析,方差不齐者行秩和检验;计数资料以率(%)表示,行?2检验;相关分析:以所有被调查的变量作为相关变量,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:(1)斑块组、脑梗组及正常对照组患者的性别、年龄、吸烟史、BMI指数、血压、HDL-C差异无统计学意义(P0.05),脑梗组与对照组比较TC、TG、LDL-C、Hb A1、HCY、CPR差异有统计学意义(P0.05);脑梗组与斑块组比较TC、TG、LDL-C、Hb A1、HCY差异有统计学意义(P0.05);斑块组与对照组比较TG、CPR差异有统计学意义(P0.05)。(2)脑梗组血清salusin-α水平(2.066±0.564)ng/L明显低于对照组(3.750±0.818)ng/L及斑块组(2.881±0.758)ng/L,三组间差异有统计学意义(P0.01);脑梗组血清脂蛋白相关磷脂酶A2水平(1.949±0.666)ng/ml明显高于对照组(1.426±0.406)ng/ml,及斑块组(1.703±0.541)ng/ml,三组间差异有统计学意义(P0.05);(3)logistic回归分析显示血清salusin-α水平与动脉粥样硬化不稳定斑块患者发生脑梗死呈独立负相关(OR=0.14,95%CI:0.54~3.68,P=0.000)。结论:颈动脉粥样硬化不稳定斑块患者血清salusin-α减低,脂蛋白相关磷脂酶A2水增高;血清salusin-α水平减低可能是颈动脉粥样硬化不稳定斑块患者发生脑梗死的危险因素。
[Abstract]:Objective: carotid atherosclerosis is the main cause of cerebral infarction, and its formation mechanism is very complex. In this study, the serum levels of lipid factor salusin- 伪 and inflammatory factor lipoprotein associated phospholipase A2 were measured in healthy subjects, patients with unstable carotid atherosclerotic plaques and patients with unstable plaques complicated with cerebral infarction. To investigate the relationship between serum salusin- 伪 and lipoprotein associated phospholipase A 2 (LP A 2) and cerebral infarction in patients with unstable carotid atherosclerotic plaque. Methods: from November 2014 to August 2015, 100 patients with unstable plaque of carotid atherosclerosis were selected from the Department of Neurology, the first affiliated Hospital of Medical College of Shihezi University. According to whether cerebral infarction occurred or not, they were divided into two subgroups: cerebral infarction group (n = 50) and plaque group (n = 50). And 50 cases of healthy physical examination in the same period. All participants recorded sex, age, height, weight, smoking history, early morning blood pressure on the second day after admission, fasting venous blood index including total cholesterol (Total cholesterol,TC), triglyceride (Triglyceride,TG), high density lipoprotein (Highdensitylipoproteincholesterol,HDL). Low density lipoprotein (Lowdensitylipoproteincholesterol,LDL), glycosylated hemoglobin (Hb Alc), homocysteine (HCY), C-reactive protein (CPR) and so on. Serum salusin- 伪 and lipoprotein associated phospholipase A 2 were measured by enzyme linked immunosorbent assay (ELISA). SPSS 17.0 software was used for statistical analysis. The measurement data were expressed as mean 卤standard deviation. The comparison of multiple mean values was analyzed by one-way ANOVA and rank sum test was performed for those with uneven variances. The counting data were expressed as rate (%), and the correlation analysis was performed by using all variables investigated as correlation variables and cerebral infarction as dependent variables for Logistic regression analysis to analyze the risk factors of cerebral infarction. Results: (1) there was no significant difference in sex, age, smoking history, BMI index, blood pressure and HDL-C between plaque group, cerebral infarction group and normal control group (P0.05). The difference of HCY,CPR was statistically significant (P0.05). There was significant difference in TC,TG,LDL-C,Hb A1 and HCY between cerebral infarction group and plaque group (P0.05). Comparison of TG, between plaque group and control group The level of serum salusin- 伪 in cerebral infarction group (2.066 卤0.564) ng/L was significantly lower than that in control group (3.750 卤0.818) ng/L and plaque group (2.881 卤0.758) ng/L, (P 0.05). (2). The difference of CPR was statistically significant (P 0.05). There was significant difference among the three groups (P0.01). The level of serum lipoprotein-associated phospholipase A _ 2 (1.949 卤0.666) ng/ml in cerebral infarction group was significantly higher than that in control group (1.426 卤0.406) ng/ml, and plaque group (1.703 卤0.541) ng/ml, group (P0.05). (3) logistic regression analysis showed that there was an independent negative correlation between serum salusin- 伪 level and cerebral infarction in patients with unstable atherosclerotic plaque (OR=0.14,95%CI:0.54~3.68,P=0.000). Conclusion: the decrease of serum salusin- 伪 and the increase of lipoprotein associated phospholipase A2 in patients with unstable carotid atherosclerotic plaque may be the risk factors of cerebral infarction in patients with unstable carotid atherosclerotic plaque, and the decrease of serum salusin- 伪 level may be the risk factor of cerebral infarction in patients with unstable carotid atherosclerotic plaque.
【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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