| ObjectiveLipoprotein-related phospholipase A2(Lp-PLA2)is a new inflammatory marker closely closely related to arteriosclerosis and ischemic cardiovascular and cerebrovascular diseases,However,the current study on the relationship between Lp-PLA2 concentration and acute ischemic stroke(AIS)is unclear.This study investigated the relationship between Lp-PLA2 concentration and carotid intima-media thickness(cIMT)and plaque properties in patients with AIS,as well as the correlation between Lp-PLA2 concentration and cerebral infarction recurrence,in order to determine the effect of Lp-PLA2 on ischemia Clinical value of stroke patients.MethodsUsing a retrospective study design,a total of 293 patients with AIS who were hospitalized in the Department of Neurology,The First People’s Hospital of foshan from 2018 to 2019 were selected.The concentration of serum Lp-PLA2 was measured,and color Doppler ultrasound was used to measure the cIMT thickness and plaque morphology of bilateral carotid arteries.According to the nature of cIMT thickness and plaque morphology,they were divided into control group and intimal thickening group,control group and vulnerable plaque group,and according to the recurrence or not within 1 year after cerebral infarction,they were divided into control group and recurrence group.Logistic regression analysis,trend analysis and curve fitting were used to explore the effect of Lp-PLA2 concentration on cIMT and plaque properties and its correlation with the recurrence of cerebral infarction.Finally,(ROC)curve was drawn to explore Lp-PLA2 Predictive ability of concentration on the risk of cerebral infarction vulnerable plaque occurrence and recurrence.ResultsCIMT and plaque properties were studied in 293 patients.The average follow-up was 1 year,and 7 cases were lost to follow-up.286 cases were included in the risk study of recurrence.1.There were 124 cases of carotid intimal thickening group,compared with the control group,the difference in Lp-PLA2 concentration between the two groups was statistically significant(P<0.05).In regression analysis,after adjustment for relevant risk factors,compared with the lowest tertile of the Lp-PLA2 concentration,the highest tertile had a 1.431-fold increased risk of cIMT thickening(OR=2.431,95%CI:1.196-4.942,P=0.01415).2.There were 83 cases in the vulnerable plaque group.Compared with the control group,there was a statistically significant difference in the Lp-PLA2 concentration between the two groups(P<0.05).Regression analysis showed that after adjusting for relevant risk factors,compared with the lowest tertile of Lp-PLA2 concentration,the risk of carotid vulnerable plaque increased by 4.933 times in the highest tertile(OR=5.933,95%CI:2.575-13.670,P=0.00003).The area under the ROC curve of Lp-PLA2 concentration on the risk of cIMT thickening in cerebral infarction was about 0.631,the sensitivity was 0.56,and the specificity was 0.65.The area under the ROC curve of Lp-PLA2 concentration on the risk of carotid vulnerable plaque was about 0.797,the sensitivity was 0.67,and the specificity was 0.86.3.Compared with the control group,the Lp-PLA2 concentration in the recurrence group(38 cases)was significantly increased,and there was a significant difference(P<0.05).Serum Lp-PLA2 concentration was positively correlated with the recurrence of cerebral infarction.After adjusting for relevant risk factors in regression analysis,it was found that compared with the lowest tertile of the Lp-PLA2 concentration,the risk of cerebrovascular recurrence in the highest tertile increased by 4.026 times(OR=5.026,95%CI:1.493-16.922,P=0.00913).The area under the ROC curve of Lp-PLA2 concentration on the risk of cerebral infarction recurrence was about 0.749,with a sensitivity of 0.80 and a specificity of 0.89.Main conclusion1.Serum Lp-PLA2 concentration is an independent risk factor for cIMT thickening and vulnerable plaque formation in patients with cerebral infarction,and Lp-PLA2 concentration can be used as a reference index for predicting the formation of carotid vulnerable plaque in patients with cerebral infarction and for early intervention.2.Serum Lp-PLA2 concentration is an independent risk factor for the recurrence of cerebral infarction,and it is expected to be an indicator for predicting the recurrence of cerebral infarction. |
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