The Relationship Between Lp-PLA2 Activity And The Prognosis Of TIA

Backgroud and object:Transient ischemic attacks(TIA) is the dangeroussignal of ischemic stroke,very easy to develop into the irreversiblecerebral infarction,It is also called warning strokes abroad,therefore,as soon as possiblely seeking for the TIA cause and aiming at the cause of disease to carry on positively processes is the important means whichprevent the cerebral infarction's occuring.Atherosclerosis isone kind of chr onic inflammatory disease,the inflammation reaction thatparticipated in each link of at herosclerosis occurring play an importantpart in the beginning,development,losing the stability,rupture and fall ing off of atherosclerosis plaque.Therefore,people paid attent ion to the inflammation marker of the circulation as the forecasting index of cerebralve ssels danger the lipoprotein-associated phospholipase A2(Lp-PLA2) as inflammatory ma rkers is approved by the United States Food and Drug Administration(FDA)in 2005 to assess the danger target of ischemic stroke.It is also called the blood platelet-activati ng factor acetyl hydroltyic enzyme,Human plasma Lp-PLA2 is produced and secreted by the ripe macrophage and lymphocell.The blood platelet activating factor promoted secreting.After being releasedinto the blood,Lp-PLA2 combined with lipoprotein partic les as the existingform,80%of them combined with LDL through apo-B,20%of them combined wit HDL and VLDL through other apolipoprotein.A great quantity of study indicated that Lp-PLA2 is one piece of singificantly forecasting cerebral vesselsoccurre nce's index.According to FDA expert's introduction,on the condition of the content of low density lipoprotein cholesterol(LDL-C) lower than 130 mg/dl,Lp-PLA2 value's r aising usually means patient's stroke danger is added 2～3 times.Determining Lp-PLA2 level can provided forecasting message besides traditional dangerous factor evaluation. At present hypolipidemic is mainlyused to cure artery atherosclerosis.Lp-PLA2 as a ne w target ofnon-hypolipidemic,it's inhibiter has a wide view of precauting and curing ar tery atherosclerosis.At present the domesticand overseas study of Lp-PLA2 in patients with TIA is not easily found.The text mainly investigatesthe expression of Lp-PLA2 i n the patients with TIA and it's value in assessment of ischemic stroke'danger.Method:The selected patients with TIA in hospital from january 2008 to january 2009 all accord with TIA's diagnostic criteria passed by the forth national cerebrovascul ar disease academic conference,They are confirmed byCT or MRI.The index of all pa tient's blood serum Lp-PLA2 activity,WBC,N#,blood-fat,blood glucose,blood pressure andother indicators.at the same time collecting their age,sex,smoking historyhistory of hypertension and diabetes and so on.The health examination patients of clinic service are choose as the control according to one to one matching rules.Two groups were exclu ded from infection,stroke,heart-stroke,heart infarction,serious liver and kidney's disea se.At the follow-up period of 90 days,the recurrent TIA and ischemic stroke incident of the selected ones are recorded.Statistical methods are used for the normal control g roup and the TIA group of Lp-PLA2 activity,WBC,N#,comparison of lipid and other, With in 90 days,the TIA patients without the occurrence of cerebral infarction or TI A are choosed as the A group andthe TIA patients with the occurrence of cerebral infa rction or TIA are choosed as the B group,wecompared the two groups of Lp-PLA2 ac tivity,blood lipids,blood pressure,hyperlipidemia and other related indicators.Result:Blood serum Lp-PLA2 levels of the TIA group,WBC,NE#.TC,TG, blood pressure and blood glucose were higher than the normal control group,and HDL-C lower than the controi group.At follow-up period of 90 days TIA occurred in 5 TI A patients and cerebral infarction occurred in 4 TIA patient.Total WBC,neutrophil m odulus and Lp-PLA2 of the TIA patients withthe occurrence of cerebral infarction or T IA are higher than those in the TIA patients without the occurrence of cerebral infarcti on or TIA,HDL-C ofthe TIA group with occurrence of cerebral infarction or TIA is l ower than that in the TIA group without occurrence of CI or TIA,Lp-PLA2 level of t he patients with great drinking and heart disease is raised obviously(P＜0.05).After c ontrol of age,WBC,and N#,we found that Lp-PLA2 level is n't relatedwith total ch olesterol,TG,HDL,LDL,VLDL and LP(a),significantly after the control of age,total cholesterol,TG,HDL,LDL,VLDL and LP(a),p-PLA2 is n't related with WBC,N #,significantly.Conclusion:Lp-PLA2 can be regarded as the prognostic indicator of the patients with TIA.High level serum Lp-PLA2 of the patients signified the bad prognosis.With great drinking Lp-PLA2 level of the patients with greatdrinking and heart disease is rai sed obviously.Lp-PLA2 level is n'trelated with total cholesterol,TG,HDL,LDL,VLD L and LP(a) significantly.