The Relationship Between Lipoprotein-associated Phospholipase A2 And Atherosclerotic Thrombotic Cerebral Infarction

Background and purpose:Ischemic cerebrovascular disease is one of the multiple diseases in the elderly population.The incidence of this disease is high,and it has a high disability rate and recurrence rate,which seriously affects the physical and mental health and quality of life of elderly patients..he main cause of cerebral infarction is atherosclerosis(AS),and;clinical studies have found that lipoprotein-related phospholipase A2(Lp-PLA2)and AS have a certain correlation,and studies have found that this protease can promote arteriosclerosis The occurrence and development of sclerosis can reflect the state of plaque,which is related to the risk of cardiovascular and cerebrovascular diseases.It is an independent risk factor for predicting cardiovascular and cerebrovascular diseases.Recent studies have confirmed that Lp-PLA2 can be used as a biological marker to predict the risk of ischemic cerebrovascular disease.Detection of serum Lp-PLA2 levels can predict the occurrence of cerebral infarction.We compared the serum Lp-PLA2 levels in patients with atherosclerotic thrombotic(AT)and non-AT cerebral infarction,and analyzed the correlation between Lp-PLA2 and the extent of vascular stenosis and vascular disease in patients with AT.And its predictive value for intracranial arterial stenosis.Methods:1?Select cerebral infarction patients hospitalized in the department of gerontology of our hospital from 2015 to 2017.After MRI+MRA,cervical vascular ultrasound(bilateral common carotid artery,internal carotid artery,vertebral artery),echocardiography,patient onset time,and medical history,106 patients with AT cerebral infarction were diagnosed..Peaple in the AT cerebral infarction group,who aged 70-85 years,mean age 78.37±4.26.The non-AT group,we also chose the poeple hospitalized in our department at the same period of time.The diagnosis of non-AT cerebral infarction was confirmed by MRA+MRI,cervical vascular ultrasound(bilateral common carotid artery,internal carotid artery,vertebral artery),echocardiography,patient onset time,and medical history.As a result,fifty-two patients was included in non-AT cerebral infarction group,aged 70 to 85 years,mean age 77.15±3.42 years;2? All patients were fasted for more than 12 hours.At least 1 low-fat diet and alcohol abstinence were taken before blood samples were taken.3 ml of fasting venous blood was collected.The level of Lp-PLA2 in the serum was measured by Beijing Hot Scene Transmitted Light Analyzer.For double antibody sandwich immunochromatography;3?To detect the total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C,high density lopoprotein cholesterol,HDL-C)in the plasma using an automatic biochemical analyzer.And triglyceride(triglyceride,TG)concentration levels for statistical analysis;4?After 1.5T cranial magnetic resonance angiography(MRA)examination,the intracranial aorta(anterior cerebral artery,middle artery,posterior artery,and vertebrobasilar artery)was analyzed to determine whether there was atherosclerosis and stenosis degree and grouped according to the NASCET method: There was no atherosclerotic stenosis in the intracranial arteries in the normal group;there was atherosclerosis in the intracranial arteries in the sclerosing group and no stenosis in the vessels;intracranial arterial atherosclerosis in the mild stenosis group.The stenosis rate was less than 50%;the intracranial arterial stenosis rate ranged from 50% to 69% in patients with moderate stenosis;the severe stenosis group had stenosis rates ranging from 70% to 100%;and stenosis was mainly composed of two types.Respectively,it is limited and diffuse.For example,if a certain blood vessel has multiple stenosis,the degree of stenosis of the blood vessel can be rated as the most serious one;Statistical methods: SPSS 21.0 analysis software was used for statistical studies.Measured data were presented in mean ± standard deviation.Measurement data were compared using independent sample t test or variance analysis;multiple comparisons between groups were performed using Lsd-t test;qualitative Chi-square test was used to compare data between groups;for different arterial stenosis Lp-PLA2 levels,logistic regression was used to plot the ROC curve,and the best cut-off value was calculated based on AUC.Lp-PLA2 levels were assessed for intracranial arterial stenosis.The predictive value of the degree;correlation test of the measurement data,using the Pearson correlation coefficient.P<0.05 indicated that the difference was statistically significant.Results:1.There was no significant difference in the age,sex,smoking history,prevalence of diabetes,TC,TG,HDL-C between the AT and non-AT cerebral infarction groups(P>0.05).The concentration of Lp-PLA2 and LDL-C in the cerebral infarction group was higher than that in the non-AT cerebral infarction group.P<0.05 was statistically significant.2.In the acute cerebral infarction group,there were 23 cases with mild stenosis,49 cases with moderate stenosis,and 34 cases with severe stenosis.The levels of Lp-PLA2 were(195.16 ± 18.74),(244.60 ± 20.44),(304.80 ± 30.84)ng/ml.By one-way analysis of variance;F = 149.40,P <0.001;within the group comparison,(1)severe stenosis group Lp-PLA2 levels were higher than light,moderate stenosis group,P <0.001;difference statistically significance;(2)The level of Lp-PLA2 in the moderately stenosis group was higher than that in the mild stenosis group,P<0.001;the difference was statistically significant;3.The ROC curves of the three groups of intracranial arterial stenosis data were used to draw:(1)The cut-off point was 215.03 ng/ml,and the Lp-PLA2 was greater than 215.03 ng/ml,which was judged as moderately severe.The sensitivity was 91%,the specificity was 99%,the area under the ROC curve was 0.9843,(2)the cut-off point was 253.69 ng/ml,the Lp-PLA2 was greater than 253.69 ng/ml,and it was judged as severe.The sensitivity was 97% and the specificity was 82%,the area under the ROC curve is 0.9641;4.There were 20 patients with single-vessel disease in the cerebral infarction group and 86 patients with multi-vessel disease.The levels of Lp-PLA2 were(201.67± 29.20)and(265.16 ± 41.89)ng/ml,respectively,P<0.05,the difference was statistically significant;.5.Correlation analysis found that Lp-PLA2 was positively correlated with LDL-C,vascular stenosis,and extent of vascular lesions(P<0.05),and had no correlation with other indicators(P>0.05).Conclusion:1.Lp-PLA2 has a close relationship with atherosclerotic cerebral infarction,and it can be used as a predictor of atherosclerotic thrombotic(AT)cerebral infarction.2.By measuring the concentration of Lp-PLA2 in the test population,the extent of intracranial arterial stenosis and the extent of vascular lesions can be effectively evaluated.This is more conducive to the early preventive treatment of patients and reduce the incidence of atherosclerotic cerebral infarction.