Study On The Relationship Between Lp-PLA2, CD40/CD40L And The Vulnerable Atherosclerotic Plaques In Patients With Middle Cerebral Artery Stenosis

ObjectiveLipoprotein-Associated Phospholipase A2（Lp-PLA2） and thesignaling protein CD40and its ligand, CD40L, are thought to contributeatoatherosclerotic plaque formation and rupture. We sought to studyLp-PLA2and CD40and its ligand CD40L levels in serum of patientswith the vulnerable atherosclerotic plaques of cerebral middle arteryMethodsWe recruited24patients with middle cerebral artery (MCA)-typystroke with stenosis, in that microembolic signals (MES)positive(MwSMES+),19patients with MCA-typy stroke with stenosis, in thatmicroembolic signals negative (MwS MES-),19patients with MCA-typy stroke without stenosis（MwOS MES-）. We also recruited19healthy individuals as controls(Con).Lp-PlA2and CD40/CD40L wasmeasured by ELISA.ResultsThe mean age of MwS MES+, MwS MES-, MwOS MES-andhealthy controls is56.62±11.83years,55.05±10.91years,55.16±11.53years，56.62±11.83years；There are20male and4female in MwS MES+group. There are16male and3female in MwS MES-group.There are16male and3female in MwOS MES-group. There are16male and3female in healthy controls. By comparing the patients with acutecerebral infarction MwS MES+, MwS MES-, MwOS MES-and healthy controls,there is no difference of age and sex (P＞0.05).There is noinfluence each other in hypertension, diabetes, cardiac disease andsmoking. The concentrations of Lp-PlA2in patients with MwS MES+,MwS MES-, MwOS MES-and healthy controls are11.63±7.70ug/ml,15.67±9.99ug/ml,16.27±12.38ug/ml,18.94±12.78ug/ml.There isdifferent in each other(MwS MES+v.s Con,P=0.007).The concentrationof CD40in four groups are30.43±55.82ug/ml,13.3±12.32ug/ml,11.37±12.8ug/ml,4.50±12.9ug/ml. There is different eachother(MwOS MES-v.s MwS MES-, MwOS MES-v.s MwS MES+, P＜0.017). The concentration of CD40L in four groups are9.57±4.96ug/ml,8.52±2.7ug/ml,11.50±4.60ug/ml,23.37±6.57ug/ml.There is nodifferent in four groups (P＞0.05).By comparing the volume of cerebralinfarction and the concentration of Lp-PlA2and CD40/CD40L,there is nodifference (P＞0.05).By comparing the influence including cerebralinfarction,artery steins,hypertension, diabetes, cardiac disease,smoke,Lp-PlA2and CD40/CD40L than whether microembolic signals ispositive,there is CD40affected by whether microemblic signals positive(P=0.035) through multivariate logistic regression analysis.Conclusions：1.Multivariate logistic regression analysis showed CD40isindependent predictor for vulnerable atherosclerotic plaques of cerebralmiddle artery. When the vulnerable atherosclerotic plaques of cerebralmiddle artery is more amphibolic, the concentration of CD40is increased.We conclude that CD40is could be used as a clinical biomarker forassessing atherosclerotic instability.2.The volume of cerebral infarction is not the influence whichaffects the concentration of Lp-PLA2,CD40/CD40L.