血清亲环素A与颈动脉不稳定斑块及脑梗死的相关性研究

Correlation of cyclophilin A with unstable carotid plaques and atherosclerotic cerebral infarction

摘要:

目的  通过检测颈动脉硬化不稳定斑块伴动脉粥样硬化脑梗死（ACI）患者（ACI组）、颈动脉硬化不稳定斑块患者（单纯斑块组）及健康体检者（对照组）血清亲环素A（CyPA）、脂蛋白相关磷脂酶A2（Lp-PLA2）水平，探讨观察者血清CyPA、Lp-PLA2水平与斑块不稳定性及ACI的关系。方法  颈动脉粥样硬化斑块经颈部血管彩色超声检查确定；采用双抗体夹心酶联免疫吸附法（ELISA）测定观察者血清CyPA、Lp-PLA2水平。结果  患者的血清CyPA水平ACI组（2.031±0.679）ng/ml>斑块组（3.790±0.943）ng/ml>对照组（5.113±1.568）ng/ml，差异有统计学意义（P <0.05）；血清Lp-plA2水平ACI组（1.949±0.666）ng/ml>斑块组（1.703±0.541）ng/ml>对照组（1.426±0.406）ng/ml，差异有统计学意义（P <0.05）。Logistic回归分析显示，CyPA是不稳定斑块患者发生脑梗死的独立危险因素（■=2.71，95%CI：1.52，4.83，P =0.01）。以CyPA、Lp-PLA2为双变量行相关分析显示两者呈正相关（r=0.343）。结论  血清CyPA、Lp-PLA2水平可作为颈动脉不稳定斑块的临床标志物；联合检测血清CyPA、Lp-PLA2水平可能会预测ACI的发生。

Abstract:

Objective To investigate the relationships of plasma levels of cyclophilin A (CyPA) and lipoprotein-association phospholipase A2 (Lp-PLA2) with the unstability of carotid plaques and atherosclerotic cerebral infarction (ACI). Methods Carotid atherosclerotic plaques were defined by cervical vascular color ultrasonic inspection. The plasma levels of CyPA and Lp-PLA2 were detected by enzyme linked immunosorbent assay (ELISA) in patients with unstable carotid atherosclerosis plaques and ACI (ACI group), patients with unstable carotid atherosclerosis plaques (simple plaque group) and in healthy people (control group). Results The plasma level of CyPA in the ACI group [(2.031 ± 0.679) ng/ml] was significantly higher than that in the simple plaque group [(3.790 ± 0.943) ng/ml], which was in turn higher than that in the control group [(5.113 ± 1.568) ng/ml] (P < 0.05). The plasma level of Lp-PLA2 in the ACI group [(1.949 ± 0.666) ng/ml] was significantly higher than that in the simple plaque group [(1.703 ± 0.541) ng/ml], which was in turn higher than that in the control group [(1.426 ± 0.406) ng/ml] (P < 0.05). Logistic regression analysis showed that CyPA was the independent risk factor for cerebral infarction in the patients of unstable plaques (■= 2.71; 95% CI: 1.52, 4.83; P = 0.01). Correlation analysis showed CyPA and Lp-PLA2 were in a positive correlation (r = 0.343). Conclusions Plasma CyPA and Lp-PLA2 levels can be used as clinical markers of unstable carotid plaques. Joint detection of CyPA and Lp-PLA2 could predict the occurrence of ACI.