Effect Of HbA1c And Lp-PLA₂ On Carotid Artery Vulnerable Plaque In Patients Of Cerebral Infarction With Type 2 Diabetes Mellitus

Objective:To investigate the effects of glycosylated hemoglobin on carotid plaque stability,component and lipoprotein-related phospholipase A₂?Lp-PLA₂?in patients of cerebral infarction with type 2 diabetes mellitus.Methods:91 patients with cerebral infarction admitted to the Department of Neurology,Second Hospital Hospital of Hebei Medical University from Feb2016 to Dec 2016 were divided into two groups: non-diabetic group and diabetic group.According to the different levels of HbA1 c,the diabetic group was divided into three subgroups,good blood glucose control group A: HbA1c<7.0%,poor blood glucose control group B:HbA1c 7.0% to 9.0% and group C: HbA1 c > 9.0%.Serum Lp-PLA₂ of all the patients was detected by enzyme-linked immunosorbent assay?ELISA?and ultrasonic examination to confirm the incidence of carotid artery plaques,some patients with type II plaque were examined by carotid artery high-resolution nuclear magnetic.To compare the stability and composition of carotid plaques and serum Lp-PLA₂ in four groups of patients,and to analyze the effects of different Hb A1 c levels on serum Lp-PLA₂ level and carotid plaque stability and composition in patients with cerebral infarction.Results:1 There is no statistical difference between the non-diabetic group and the subgroups of diabetes mellitus in gender,age,serum uric acid,and history of hypertension?P>0.05?;there is statistical difference between the four groups in the level of low-density lipoprotein cholesterol?P<0.05?.2 There is a correlation between the level of Hb A1 c and the classification of vulnerable segments of carotid artery,and the correlation coefficient C is0.263,?P <0.05?,which is statistically significant.3 There is statistical difference between the groups A,B,C and the non-diabetic group in the level of Lp-PLA₂,which is statistically significant?P<0.05?.Lp-PLA₂ of Group C differs from group A,B,which is statistically significant?P<0.05?.But there is no statistical difference between the group A and the group B?P>0.05?.4 Plasma Lp-PLA₂ levels were positively correlated with lipid necrotic tissue area of carotid plaques?r=0.706,P<0.05?.Conclusion:1 The level of HbAlc in patients of cerebral infarction complicated with type 2 diabetes mellitus affects the carotid plaque component,which is mainly the core component of lipid necrosis.2 The level of serum Lp-PLA₂ in patients with cerebral infarction complicated with type 2 diabetes mellitus was significantly higher.3 The area of lipid necrosis in carotid plaques is associated with LP-PLA₂ levels.