| Objective: The data shows that China has entered the aging society. Ageing population is currently close to 200 million, and an average annual growth rate of more than 10 million, by mid-century to reach 30% of the whole population. Incapacitating and semi-disabled elderly has more than 37 million, almost 10% of them are Cerebral infarction patients. With a high incidence, mortality, morbidity of cerebral infarction which serious threats our lives, takes a heavy burden to the social and family. In recent years, extensive research at home and abroad, has proved Lipoprotein-associated phospholipase2(Lp-PLA2) plays a role in inflammatory processes even in atherosclerotic plaque’s arising development and rupture, as a newly discovered inflammatory factors. Also A series of studies showed that Lp-PLA2 have some relevances, such as prevention diagnosis and assessment, with coronary heart disease and cerebrovascular disease. In this test, we detect the plasma levels of Lp-PLA2 in elderly patients with acute carotid atherosclerosis cerebral infarction. Analysis the relationship between acute carotid atherosclerotic cerebral infarction and Lp-PLA2. And to further explore the value of Lp-PLA2 in cerebral infarction diagnosis, treatment and disease evaluation.Methods: The study choices elderly acute Atherosclerotic Cerebral Infarction(ACI) patients 100 cases of geriatrics department in the third hospital of Shijiazhuang(from December 2013 to January 2015).As well as divided into experimental group(100cases: male 56,female44, average age(76.49±7.75).) and control group(30cases: male 18,female12, average age(77.20±8.46).). Case group inclusion criteria:(1) by the fourth national cerebrovascular disease conference on revision of the diagnostic criteria for ischemic stroke in1995, the body conform to the carotid artery system cerebral infarction clinical characteristics, and confirmed by head CT or MRI.(2) within 72 hour of the hospital. Exclusion criteria:(1) cerebral infarction vertebral basilar artery system.(2) artery inflammation combined.(3) hemorrhagic cerebral infarction or hemorrhage after infarction conversion, small vascular cerebral infarction, cardiac or tumors, cerebral embolism.(4) caused by congenital dysplasia cerebral infarction.(5) has a cardiovascular diseases, diseases of the blood system. Control grope inclusion criteria: no TIA and previous history of cerebral infarction, there is no history of coronary heart disease, now no ischemic cerebrovascular disease symptoms, cranial CT or MRI confirmed not cerebral infarcts. Experimental group, according to the nerve function defect(by the NIHSS score) divided into mild, moderate and severe groups. Basing on cerebral infarction volume divided into small, mild and large groups. According to the nature of the extracranial carotid plaques were divided into stable plaque group and the unstable plaque group. Compared with physical examination center of healthy elderly medical control.Both groups acquisition age, sex, smoking, drinking and other general situation and history contrast analysis such as diabetes, high blood pressure. Using the UPT method to determinate the Lp-PLA2 level. All measured values were analysed by the 13.0 SPSS software.Results: 1 In the two groups general and biochemical data contrast 1.1 Compared with control group, the difference of age, sex composition and proportion of smokers and drinkers, has no statistical significance(P>0.05). Proportion of patients with hypertension, diabetes mellitus, the difference was statistically significant(P<0.05). 1.2 Senate inquiry patients plasma CHOL, LDL level is higher than the contro l group(all P<0.05), comparing the two groups have statistical significance. HDL level is lower than the control group(P<0.05), two groups are statisticall y significant. But FIB compared in the two groups has no statistical significan ce(P>0.05).2 Experimental group compared with control group Lp-PLA2 level 2.1 Cases group was obviously higher than that of control group(P<0.05), comparing the two groups have statistical significance. Total cases plaques was significantly increased(P<0.05), with statistical significance. Cases of unstable plaque group plasma LP-PLA2 level obviously higher than that of stable plaque group, comparing the two groups was statistically significant(P<0.05). 2.2 Different plasma Lp-PLA2 level of patients with cerebral infarction group increases with the illness weight(P<0.05), three groups are statistically significant. Lp-PLA2 level in patients with increasing with the increase of cerebral infarction volume, comparing different volume was statistically significant(P<0.05).Conclusion: In elderly patients with acute carotid atherosclerotic cerebral infarction, the level of Lp-PLA2 increased with illness weight, Increases with the cerebral infarction volume, plasma Lp-PLA2 level also gradually increases. Unstable plaque ratio is greater than the stable plaques, and unstable plaque group of plasma Lp-PLA2 level increase than the stability of plaque group. In patients with ACI, The higher the level of Lp-PLA2, the illness is heavier the worse prognosis. Lp-PLA2 levels in aged carotid artery atherosclerosis is an important risk factor for cerebral infarction, Lp-PLA2 and carotid atherosclerotic cerebral infarction is related, and it also related to the severity of the associated with carotid atheromatous plaque stability. |
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