Liu Yuan, Zhu Jinhua, Deng Xuhui, Yang Zhi, Chen Chunchun, Huang Shuxuan, Chen Lue, Ma Ying, Lin Weifeng, Zhu Feiqi
Department of Neurology, The Affiliated Yue Bei People's Hospital of ShantouUniversity Medical College, Shaoguan, 512025, Guangdong, People's Republic of China.
Department of Neurology, The Third People's Hospital of Hangzhou, Hangzhou, 310009, Zhejiang, People's Republic of China.
Neurol Sci. 2021 Feb;42(2):599-605. doi: 10.1007/s10072-020-04563-7. Epub 2020 Jul 9.
There are no effective therapies to prevent the occurrence and progression of vertebrobasilar dolichoectasia (VBD). In this study, we investigated the relationship between serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and the occurrence and progression of VBD.
Sixty (60) cases without VBD and ischemia stroke were considered as Group A, 100 cases with VBD were further divided into Group B (VBD without ischemic stroke, n = 54) and Group C (VBD with first ever acute posterior circulation ischemic stroke, n = 46). Demographic data (such as gender and age) and past medical history (such as hypertension, diabetes, and smoking history) were collected. The levels of serum low-density lipoprotein cholesterol (LDL-C), hypersensitivity C reactive protein (hs-CRP), glycosylated hemoglobin (HbAlc), homocysteine (HCY), uric acid (UA), fibrinogen (Fib), and Lp-PLA2, etc. were measured. Logistic regression analysis was used to assess the related factors of VBD and ischemic stroke secondary to VBD.
Logistic multivariate regression analysis showed that only age and the level of serum Lp-PLA2 were significantly higher in group B than those in group A (P < 0.012, P < 0.001, respectively), however, only the level of serum Lp-PLA2 was significantly higher in group C than those in group B (P < 0.001).
The serum marker Lp-PLA2 is an independent risk factor for the occurrence of VBD and the progression of VBD to posterior circulation ischemic stroke. Whether intervening on atherosclerosis could prevent the occurrence and development of VBD needs to be further studied.
目前尚无有效的疗法来预防椎基底动脉延长扩张症(VBD)的发生和进展。在本研究中,我们调查了血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平与VBD发生及进展之间的关系。
将60例无VBD和缺血性卒中的患者作为A组,100例VBD患者进一步分为B组(无缺血性卒中的VBD,n = 54)和C组(首次发生急性后循环缺血性卒中的VBD,n = 46)。收集人口统计学数据(如性别和年龄)和既往病史(如高血压、糖尿病和吸烟史)。检测血清低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbAlc)、同型半胱氨酸(HCY)、尿酸(UA)、纤维蛋白原(Fib)和Lp-PLA2等水平。采用逻辑回归分析评估VBD及VBD继发缺血性卒中的相关因素。
逻辑多元回归分析显示,仅B组的年龄和血清Lp-PLA2水平显著高于A组(分别为P < 0.012,P < 0.001),然而,仅C组的血清Lp-PLA2水平显著高于B组(P < 0.001)。
血清标志物Lp-PLA2是VBD发生以及VBD进展为后循环缺血性卒中的独立危险因素。干预动脉粥样硬化是否能预防VBD的发生和发展有待进一步研究。