CAJ | 학술논문

[目的]探讨脑梗死患者血清脂蛋白相关磷脂酶A2（Lp-PLA2）及同型半胱氨酸（HCY）水平与颈动脉粥样硬化的相关性。[方法]选择颈动脉粥样硬化性脑梗死患者（脑梗死组，76例）和健康体检者（对照组，60例）为研究对象，应用颈动脉彩色多普勒超声检查颈动脉内膜中层厚度（IM T ），检测所有研究对象血清Lp-PLA2、HCY水平，并行相关分析。[结果]①脑梗死组的Lp-PLA2、HCY、IM T均显著高于对照组，且两组相比较差异均有显著性（ P ＜0．01）。②脑梗死组易损斑块的比例（39．2％）明显高于对照组（14．3％），且两组相比较差异有显著性（ P＜0．05）。③易损斑块组血清Lp-PLA2、IM T明显高于稳定斑块组，且两者相比较差异有显著性（ P ＜0．01）。④稳定斑块组血清Lp-PLA2、HCY和IM T均高于无斑块组，且两组相比较差异有显著性（ P ＜0．05）。⑤血清Lp-PLA2辅助识别易损斑块特异性高于 HCY。[结论]与 HCY比较，血清Lp-PLA2与颈动脉粥样硬化易损斑块的相关性更好；血清Lp-PLA2能反映斑块的不稳定，可作为临床预测脑梗死的血清学指标。
[목적]탐토뇌경사환자혈청지단백상관린지매A2（Lp-PLA2）급동형반광안산（HCY）수평여경동맥죽양경화적상관성。[방법]선택경동맥죽양경화성뇌경사환자（뇌경사조，76례）화건강체검자（대조조，60례）위연구대상，응용경동맥채색다보륵초성검사경동맥내막중층후도（IM T ），검측소유연구대상혈청Lp-PLA2、HCY수평，병행상관분석。[결과]①뇌경사조적Lp-PLA2、HCY、IM T균현저고우대조조，차량조상비교차이균유현저성（ P ＜0．01）。②뇌경사조역손반괴적비례（39．2％）명현고우대조조（14．3％），차량조상비교차이유현저성（ P＜0．05）。③역손반괴조혈청Lp-PLA2、IM T명현고우은정반괴조，차량자상비교차이유현저성（ P ＜0．01）。④은정반괴조혈청Lp-PLA2、HCY화IM T균고우무반괴조，차량조상비교차이유현저성（ P ＜0．05）。⑤혈청Lp-PLA2보조식별역손반괴특이성고우 HCY。[결론]여 HCY비교，혈청Lp-PLA2여경동맥죽양경화역손반괴적상관성경호；혈청Lp-PLA2능반영반괴적불은정，가작위림상예측뇌경사적혈청학지표。
[Objective] To explore the relationship of serum lipoprotein associated phospholipase A 2(Lp-PLA2 ) and homocysteine(HCY) with carotid artery atherosclerosis .[Methods]The patients with carotid ath-erosclerotic cerebral infarction(cerebral infarction group ,n =76) and healthy controls(control group ,n =60) were enrolled in the study .Carotid color doppler ultrasonography was used to measure intimal-medial thick-ness(IMT) of internal carotid artery .Serum levels of Lp-PLA2 and HCY in all subjects were examined for cor-relation analysis .[Results] The levels of Lp-PLA2 ,HCY and IMT in cerebral infarction group were signifi-cantly higher than those in control group ( P < 0 .01) .The ratio of vulnerable plaque in cerebral infarction group(39 .2% ) was obviously higher than that in control group(14 .3% ) ,and there was significant difference between two groups( P<0 .05) .Serum levels of Lp-PLA2 and IMT in vulnerable plaque group were obviously higher than those in stable plaque group ,and there we significant difference between two groups ( P<0 .01) . Serum levels of Lp-PLA2 ,HCY and IMT in stable plaque group were higher than those in no plaque group , and there was significant difference( P<0 .05) .The specificity of serum Lp-PLA2 for discriminating vulnera-ble plaque of carotid atherosclerosis was stronger than that of HCY .[Conclusion]Compared with HCY ,serum Lp-PLA2 has better correlation with vulnerable plaque of carotid atherosclerosis .Serum Lp-PLA2 can reflect the unstability of plaque and be used as a serological biomarker to predict cerebral infarction .