缺血性脑卒中患者血浆MPO和Lp-PLA2的表达水平及临床意义
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摘要
目的:探讨血浆髓过氧化物酶(MPO)和脂蛋白相关磷脂酶A2(Lp-PLA2)的表达与缺血性脑卒中患者颈动脉斑块稳定性及神经功能缺损程度的关系。方法:将96例缺血性脑卒中患者根据颈动脉彩超结果分为稳定斑块组(36例)、不稳定斑块组(41例)、无斑块组(19例),采用美国国立卫生研究所卒中量表(NIHSS评分)对三组的神经功能缺损程度进行评估。选取同期45例健康体检者为对照组。使用酶联免疫吸附法(ELISA)检测血浆中MPO和LpPLA2的水平。结果:病例组患者MPO和Lp-PLA2水平均明显高于对照组,斑块稳定组、斑块不稳定组MPO、LpPLA2水平高于无斑块组,并且斑块不稳定组高于斑块稳定组,差异均具有统计学意义(P<0.05);神经功能缺损程度随血浆MPO、Lp-PLA2水平增加而呈递增趋势;血浆MPO、Lp-PLA2水平与NIHSS评分均呈正相关(r=0.861,0.849,P<0.05)。结论:缺血性脑卒中患者血浆MPO和Lp-PLA2水平明显升高,与颈动脉斑块稳定性和神经功能缺损程度相关。
Objective To investigate the relationship between plasma myeloperoxidase(MPO) and lipoprotein-associated phospholipase A2(Lp-PLA2) level with the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with ischemic stroke.Method 96 cases of patients with ischemic stroke were divided into stable plaque(36 cases),unstable plaque(41 cases) and non-plaque(19 cases) according to results of carotid artery ultrasonography,evaluated the degree of neurologic impairment by American National Institutes of health stroke scale(NIHSS score) in three patients groups.and 45 healthy vounteers were selected as control group at the same period.Plasma levels of MPO and Lp-PLA2 were determined by ELISA.Results The levels of Plasma MPO and Lp-PLA2 were significantly higher in case group than those in control group,and they were higher in stable plaque group and unstable plaque group than non-plaque group,it was higher in unstable plaque group than stable plaque group,the differences were statistical significant(P<0.05);The severity of neurological impairment increased with the levels of plasma MPO and Lp-PLA2,The NIHSS score was positively correlated with the levels of plasma MPO and Lp-PLA2(r=0.861,0.849,P<0.05).Conclusion Plasma MPO and Lp-PLA2 increases significantly in patients with Ischemic stroke,and The level changes of two is closely related to the stability of carotid atherosclerotic plaque and the severity of neurological impairment
Objective To investigate the relationship between plasma myeloperoxidase(MPO) and lipoprotein-associated phospholipase A2(Lp-PLA2) level with the stability of carotid artery atherosclerotic plaque and the severity of neurological impairment in patients with ischemic stroke.Method 96 cases of patients with ischemic stroke were divided into stable plaque(36 cases),unstable plaque(41 cases) and non-plaque(19 cases) according to results of carotid artery ultrasonography,evaluated the degree of neurologic impairment by American National Institutes of health stroke scale(NIHSS score) in three patients groups.and 45 healthy vounteers were selected as control group at the same period.Plasma levels of MPO and Lp-PLA2 were determined by ELISA.Results The levels of Plasma MPO and Lp-PLA2 were significantly higher in case group than those in control group,and they were higher in stable plaque group and unstable plaque group than non-plaque group,it was higher in unstable plaque group than stable plaque group,the differences were statistical significant(P<0.05);The severity of neurological impairment increased with the levels of plasma MPO and Lp-PLA2,The NIHSS score was positively correlated with the levels of plasma MPO and Lp-PLA2(r=0.861,0.849,P<0.05).Conclusion Plasma MPO and Lp-PLA2 increases significantly in patients with Ischemic stroke,and The level changes of two is closely related to the stability of carotid atherosclerotic plaque and the severity of neurological impairment
引文
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[14]陈仁玉,王惠娟,陈哲,等.人血浆脂蛋白相关磷脂酶A2与脑梗死患者颈动脉斑块稳定性关系[J].中国免疫学杂志,2013,29(12):1293.
[15]胡晓琳,高静.缺血性脑卒中患者血浆脂蛋白相关磷脂酶A2检测的临床意义[J].检验医学,2015,30(9):968.
[16]王磊,章莹,费世早,等.动脉粥样硬化性梗死患者血浆脂蛋白相关磷脂酶A2水平及相关性研究[J].卒中与神经疾病,2011,3(18):158.
[2]张晶,龙小艳.颈动脉狭窄程度及血浆髓过氧化物酶水平对缺血性脑卒中的影响[J].临床与病理杂志,2014,34(3):248.
[3]Reddy R K Y V,Mahendra J,Gurumurthy P,et al.Identification of Predictable Biomarkers in Conjunction to Framingham Risk Score to Predict the Risk for Cardiovascular disease(CVD)in Non Cardiac Subjects[J].Journal of Clinical&Diagnostic Research Jcdr,2015,9(2):23.
[4]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中华神经科杂志,2010,43(2):146.
[5]中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南.2012[J].中华神经科杂志,2012,43(2):154.
[6]Bentsen L,Nygard A,Ovesen C,et al.Vascular pathology in the extracranial vertebral arteries in patients with acute ischemic stroke[J].Cerebrovasc Dis Extra,2014,4(1):19.
[7]Morrow D A,Sabatine M S,Brennan M L,et al.Concurrent evaluation of novel cardiac biomarkers in acute coronary syndrome:myeloperoxidase and soluble CD40 ligand and the risk of recurrent ischaemic events in TACTICS-TIMI 18[J].European Heart Journal,2008,29(9):1096.
[8]Rudolph V,Steven D,Gehling UM,et al.Coronary plaque injury triggers neutrophil activation inpatients with coronary artery disease[J].Free Radic Biol Med,2007,42(4):460.
[9]胡玉英,刘泰,胡跃强,等.中青年颈动脉硬化患者血浆髓过氧化物酶、颈动脉斑块类型与缺血性脑卒中关系的研究[J].中西医结合心脑血管病杂志,2013,11(8):911.
[10]任建兵,戴世荣,王兴山,等.髓过氧化物酶检测对急性缺血性脑卒中的临床意义[J].国际检验医学杂志,2016,37(20):2854.
[11]RIBA-LLENAL,PENALBA A,PELEGRI D,et al.Role of lipoprotein-associated phospholipase A2 activity for the prediction of silent brain infarcts in women[J].Atherosclerosis,2014,237(2):811.
[12]Colley KJ,Wolfert RL,Cobble ME.Lipoprotein associated phospholipase A(2):role in atherosclerosis and utility as a biomarker for cardiovascular risk[J].EPMA J,2011,2(1):27.
[13]Wang L,Zhang Y,Fei SZ,et al.Predictive value of plasma lipoprotein-associated phospholipase A2 in progressive cerebral infarction[J].J Clin Neurol,2011,24:308.
[14]陈仁玉,王惠娟,陈哲,等.人血浆脂蛋白相关磷脂酶A2与脑梗死患者颈动脉斑块稳定性关系[J].中国免疫学杂志,2013,29(12):1293.
[15]胡晓琳,高静.缺血性脑卒中患者血浆脂蛋白相关磷脂酶A2检测的临床意义[J].检验医学,2015,30(9):968.
[16]王磊,章莹,费世早,等.动脉粥样硬化性梗死患者血浆脂蛋白相关磷脂酶A2水平及相关性研究[J].卒中与神经疾病,2011,3(18):158.