| Research backgroundCerebrovascular disease is the first death cause of residents in our country,its high incidence and high morbidity and high mortality bring enormous economic and psychological burden to individuals,families,and society,and damage to people’s health seriosly.According to statistics,80% of them were cerebral ischemic stroke,and recent research has suggested that Non-disabling ischemic cerebrovascular events is the Optimal treatment opportunity for the prevention and control of cerebral vascular disease in China.And how to identify the non-disabled ischemic stroke early,and intervene as soon as possible that becomes very important.But unfortunately,there is a lack of reliable molecular markers predicting high risk of non-disabling cerebral ischemic stroke.Lipoprotein associated phospholipase A2(Lp-PLA2)is a kind of catalytic lipoprotein and cell membrane glycerop-holipids two acyl ester bond hydrolysis,the formation of free fatty acid,and lysophospholipid family of enzymes,its relationship with atherosclerosis has caused great concern to the people.Therefore,it is very urgent to strengthen the risk assessment and classification of carotid artery stenosis,and it has very important clinical significance and social significance.ObjectiveTo discuss the expression of lipoprotein phospholipase A2(Lp-PLA2)in patients with carotid stenosis and observe the relationship between Lp-PLA2 and cognitive function and ending vascular events by detecting the lever of Lp-PLA2 in patient with NICE.Method102 patients with carotid stenosis(case group)and 43 healthy subjects(control group)were selected as the study subjects.Lp-PLA2 level of All subjects were tested by ELISA.According to carotid stenosis,plaque characteristics,patients were divided into A,B,C group,mild,moderate and severe stenosis group,stable plaque and vulnerable plaquegroup.The primary end point was the cognitive function score(MoCA score)after following up 2 years,and the secondary endpoint was the occurrence of vascular events.Result(1)Comparing to the control group,the levels of Lp-PLA2 were significantly increased in patients with mild to severe stenosis,and the levels of Lp-PLA2 were significantly increased in patients with severe stenosis,and the difference was showed with statistically significant(P<0.05 or P<0.01).(2)Comparing to the control group,the level of Lp-PLA2 was significantly increased in patients with stable plaque group,and with the vulnerable plaque group,and the difference was statistically significant(P<0.05 or P<0.01)(3)Comparing to participating the study,The MoCA score was significantly lower in group B at 24 months,group C at 12 months and 24 months,.comparing to the control group,The MoCA score was significantly lower in group B and group C at 6 months,12 months and 24 months.Comparing to groupA,The MoCA score was significantly lower in group B at 6 months and group C at 6 months,12 months and 24 months.The differences showed statistically significant(P<0.05 or P<0.01).(4)Comparing to the control group,the vascular events were significantly increased in patients with group Band C,and comparing to the group A,the vascular events in patients with C were significantly increased,the difference was statistically significant(P<0.05 or P<0.01).The Logistic regression analysis showed that MoCA score was correlated with age,hypertension,low education level and Lp-PLA2 level in patients.ConclusionThe expression of Lp-PLA2 was significantly increased in patients with carotid stenosis,and its level was significantly associated with carotid stenosis,plaque vulnerability,cognitive function and vascular events.It can be used to evaluate and predict the prognosis of patients with ischemic stroke. |
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