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外周血中脂蛋白(a)及甘油三酯与高密度脂蛋白胆固醇比值评估缺血性脑卒中患者颈动脉斑块稳定性的价值

The value of Lp(a) and TG/HDLC in peripheral blood to assess the stability of carotid plaque in patients with ischemic stroke.

作者信息

Tian Yanan, Lu Lei, Zhang Yazhao, Wei Jianhui

机构信息

Department of Neurology, Harrison International Peace Hospital, Hengshiu, People's Republic of China.

Department of Neurosurgery, Harrison International Peace Hospital, Hengshiu, People's Republic of China.

出版信息

Brain Behav. 2024 Jan;14(1):e3355. doi: 10.1002/brb3.3355.

Abstract

OBJECTIVE

The objective of this study was to investigate the relationship between lipoprotein (a) (Lp(a)), triglyceride/high-density lipoprotein cholesterol (TG/HDL-C), and the stability of carotid atherosclerotic plaque in patients with acute ischemic stroke.

METHODS

A total of 142 patients with acute ischemic stroke were selected and divided into group A (59 cases of stable plaque formation) and group B (83 cases of unstable plaque formation) according to the characteristics of carotid artery plaque formation detected by carotid color Doppler ultrasound. The serum Lp(a), lipid metabolism indexes, peripheral blood routine indexes, and related serum inflammatory factors indexes were compared between the two groups. Receiver operating characteristic curve and multivariate logistic regression model were used to analyze the relationship between each index and the formation of carotid unstable plaque.

RESULTS

There were no significant differences in serum total cholesterol (TC), HDL-C, and low-density lipoprotein cholesterol (LDL-C) between groups A and B (p > .05). The values of Lp(a), TG, and TG/HDL-C in group B were higher than those in group A, and the differences were statistically significant (p < .05). There were no significant differences in serum TC, HDL-C, and LDL-C between groups A and B (p > .05). The values of Lp(a), TG, and TG/HDL-C in group B were higher than those in group A, and the differences were statistically significant (p < .05). The values of HBA1C, Lp-PLA2, CRP, CysC, Hcy, TNF-α, neutrophils, and NLR in group B were higher than those in group A, and the differences were statistically significant (p < .05). There was no significant difference in FPG, systolic blood pressure, diastolic blood pressure, Hb, white blood cells, platelets, and lymphocytes between groups A and B (p > .05). The results of logistic regression model showed that the increase of Lp(a), TG/HDL-C, HBA1C, Lp-PLA2, CRP, CysC, Hcy, and NLR could increase the risk of carotid artery unstable plaque in patients with ischemic stroke (p < .05).

CONCLUSION

Lp(a) and TG/HDL-C have certain value in evaluating the stability of carotid atherosclerotic plaque in patients with acute ischemic stroke, and the increased levels of LP (a) and TG/HDL-C will significantly increase the risk of carotid unstable plaque in patients.

摘要

目的

本研究旨在探讨急性缺血性脑卒中患者脂蛋白(a)[Lp(a)]、甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)与颈动脉粥样硬化斑块稳定性之间的关系。

方法

选取142例急性缺血性脑卒中患者,根据颈动脉彩色多普勒超声检测的颈动脉斑块形成特征分为A组(59例形成稳定斑块)和B组(83例形成不稳定斑块)。比较两组患者血清Lp(a)、脂质代谢指标、外周血常规指标及相关血清炎症因子指标。采用受试者工作特征曲线和多因素logistic回归模型分析各指标与颈动脉不稳定斑块形成的关系。

结果

A组和B组患者血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)比较,差异无统计学意义(p>0.05)。B组Lp(a)、甘油三酯(TG)及TG/HDL-C值高于A组,差异有统计学意义(p<0.05)。A组和B组患者血清TC、HDL-C和LDL-C比较,差异无统计学意义(p>0.05)。B组Lp(a)、TG及TG/HDL-C值高于A组,差异有统计学意义(p<0.05)。B组糖化血红蛋白(HBA1C)、脂蛋白磷脂酶A2(Lp-PLA2)、C反应蛋白(CRP)、胱抑素C(CysC)、同型半胱氨酸(Hcy)、肿瘤坏死因子-α(TNF-α)、中性粒细胞及中性粒细胞与淋巴细胞比值(NLR)值高于A组,差异有统计学意义(p<0.05)。A组和B组空腹血糖(FPG)、收缩压、舒张压、血红蛋白(Hb)、白细胞、血小板及淋巴细胞比较,差异无统计学意义(p>0.05)。logistic回归模型结果显示,Lp(a)、TG/HDL-C、HBA1C、Lp-PLA2、CRP、CysC、Hcy及NLR升高可增加缺血性脑卒中患者颈动脉不稳定斑块风险(p<0.05)。

结论

Lp(a)和TG/HDL-C在评估急性缺血性脑卒中患者颈动脉粥样硬化斑块稳定性方面具有一定价值,Lp(a)和TG/HDL-C水平升高将显著增加患者颈动脉不稳定斑块风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f47/10761332/ea42d43e63be/BRB3-14-e3355-g002.jpg

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