Research About The Relationship Of Lipoprotein Phosphor Lipase A2 And Intima-media Thickness Of Common Femoral Artery With TCM Syndromes Of Atherosclerosis

Objective:By analyzing the changes of lipoprotein phospholipase A2(Lp-PLA2)and common femoral artery intima-media thickness(CFA-IMT)in of arteriosclerosis obliterans(ASO),to explore the correlation between Lp-PLA2 and CFA-IMT in ASO and their diagnostic value in ASO,and to explore the correlation between them and ASO TCM syndrome types by analyzing their changes in different TCM syndrome types of ASOMethods:In the first study,189patients with ASO were selected as the observation group and 68 patients with physical examination as the control group.The general data(sex age,smoking history,diabetes history,hypertension history),blood pressure(systolic blood pressure,diastolic blood pressure),hematological indexes{lipoprotein phospholipase A2(Lp-PLA2),hypersensitive C-reactive protein(hs-CRP),urea(BUN),creatinine(Scr),cystatin C(CysC),triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),Low density lipoprotein(LDL),lipoprotein(a)[Lp(α)]},Common femoral artery intima-media thickness(CFA-IMT)were collected from the two groups.At the same time,the course,location,clinical stage and ankle-brachial index((ABI))of patients with ASO were collected The differences of the above-mentioned indexes between the two groups were compared;the patients with ASO were stratified according to sex,age,course of disease,location,clinical stage,past history and risk grade;the risk factors of ASO were analyzed by Logistic regression;the diagnostic value of the index determined by(ROC)of the subject’s working characteristic curve;and the correlation of the index of spearman correlation analysis.In the second study,105 patients with ASO were selected,including 53 cases of blood stasis type and 52 cases of damp-heat downward injection type.The differences of the above indexes in different TCM syndrome types of ASO were compared,and the correlation between them and ASO TCM syndrome types was discussedResults:Study 1:1.Compared with the control group,the percentage of males with ASO,history of smoking,diabetes,and hypertension was higher(P<0.01);age,systolic blood pressure,BUN,Scr,Cys C,Lp(α),Lp-PLA2 level and CFA-IMT were higher(P<0.01);HDL level was lower(P<0.01).2.With the increase of age,CFA-IMT of ASO patients gradually increased(P<0.05);With the progress of Fontaine staging,hs-CRP level in ASO patients gradually increased(P<0.05);The CFA-IMT of ASO patients with history of smoking and history of hypertension is higher than that of patients without history of smoking and history of hypertension(P<0.01);The Lp-PLA2 level of ASO patients with a history of diabetes was significantly higher than that of patients without a history of diabetes(P<0.01);With the progress of risk grading,CFA-IMT level of ASO patients gradually increased(P<0.05).3.Binary logistic regression analysis showed that age,diabetes,Cys C,Lp-PLA2,and CFA-IMT were independent risk factors for ASO.4.The areas under the ROC curve of Lp-PLA2 and CFA-IMT are 0.724 and 0.830,respectively;The area under the ROC curve of the combined diagnosis of Lp-PLA2 and CFA-IMT was 0.867.5.Spearman correlation analysis showed that gender,age,smoking history,diabetes history,Cys C,TG,TC,LDL,CFA-IMT and Lp-PLA2 were positively correlated;Smoking history,Cys C,TC,Lp(α)are positively correlated with hs-CRP,HDL is negatively correlated with hs-CRP;Gender,age,smoking history,diabetes history,hypertension history,Scr,Cys C,Lp(α),Lp-PLA2 were positively correlated with CFA-IMT,and HDL was negatively correlated with CFA-IMT.Study 2:Compared with patients with blood stasis type ASO,patients with damp-heat injection type have a longer course(P<0.01),and a higher proportion of patients with history of diabetes and hypertension(P<0.01),BUN,Cys C,Lp(α),Lp-PLA2,hs-CRP level and CFA-IMT were higher(P<0.05),HDL level and ABI were lower(P<0.01).Logistic regression analysis further screened out the indicators closely related to TCM syndromes as diabetes history,hs-CRP,CFA-IMT,and ABIConclusion:1.Lp-PLA2 and CFA-IMT are closely related to the occurrence and development of ASO2.Lp-PLA2 and CFA-IMT have a certain value in the diagnosis of ASO,and the combined diagnosis of them is more valuable in the diagnosis of ASO.3.In terms of diagnostic and predictive value of ASO,Lp-PLA2 is obviously superior to hs-CRP.4.The expression levels of Lp-PLA2 and CFA-IMT are different in different syndrome types of ASO,which can be used as an effective supplement to TCM syndrome differentiation of ASO.