摘要
目的探讨颈动脉粥样硬化性脑梗死患者的血清脂蛋白(a)[lipoprotein(a),Lp(a)]水平与颈动脉狭窄程度及斑块性质的关系及其诊断效能。方法选取2023年9月—2024年9月贵州医科大学第二附属医院神经内科住院治疗的颈动脉粥样硬化性脑梗死患者50例为病例组,另选取同期来医院体检的身体健康并且无颈动脉狭窄及脑血管疾病史的健康体检者50例为对照组。比较2组的血清Lp(a)水平比较,分析病例组不同颈动脉狭窄程度、斑块性质、斑块情况患者的血清Lp(a)水平及Lp(a)水平对颈动脉粥样硬化性脑梗死发生的诊断效能。结果病例组血清Lp(a)水平(222.18±33.37)mg/L,高于对照组的(123.90±25.41)mg/L,差异有统计学意义(P<0.05)。颈动脉轻度狭窄、中度狭窄、重度狭窄患者的血清Lp(a)水平分别为(145.32±26.45)mg/L、(228.15±33.17)mg/L、(324.80±50.10)mg/L,重度狭窄患者血清Lp(a)水平高于轻、中度狭窄患者,中度狭窄患者血清Lp(a)水平高于轻度狭窄患者,差异均有统计学意义(P<0.05)。内膜增厚患者的血清Lp(a)水平为(159.21±24.20)mg/L,低于斑块形成患者的(248.53±46.00)mg/L,不稳定斑块患者的血清Lp(a)水平为(384.27±69.63)mg/L,高于稳定斑块患者的(134.02±25.14)mg/L,差异均有统计学意义(P<0.05)。Lp(a)受试者工作特征(receiver operator characteristic,ROC)曲线的曲线下面积(area under the curve,AUC)值为0.993(95%CI为0.983~1.000)(P<0.05)。结论血清Lp(a)水平越高,颈动脉狭窄程度越严重,越易出现斑块,且斑块不稳定性越高。其对颈动脉粥样硬化性脑梗死的诊断效能较高,临床应予以重视。
Objective To investigate the relationship between serum lipoprotein(a),abbreviated as Lp(a),levels and the degree of carotid artery stenosis and the nature of plaque in patients with carotid atherosclerotic cerebral infarction and its diagnostic efficacy.Methods Fifty patients with atherosclerotic cerebral infarction who were hospitalized in the department of neurology,the Second Affiliated Hospital of Guizhou Medical University,from September 2023 to September 2024 were selected as the case group,and another 50 healthy physical examiners who came to the hospital for physical examination during the same period,had good health,and had no of carotid stenosis or cerebrovascular diseases were selected as the control group.The serum Lp(a)levels of the two groups were compared,and the serum Lp(a)levels of patients in the case group with different degrees of carotid stenosis,plaque properties,and plaque conditions were analyzed,as well as the diagnostic efficacy of the Lp(a)level for the occurrence of atherosclerotic cerebral infarction.Results The serum Lp(a)level in the case group(222.18±33.37 mg/L)was significantly higher than that in the control group(123.90±25.41)mg/L,and the difference was statistically significant(P<0.05).The serum Lp(a)levels of patients with mild,moderate,and severe stenosis of carotid artery were(145.32±26.45)mg/L,(228.15±33.17)mg/L,and(324.80±50.10)mg/L,respectively.The serum Lp(a)levels of patients with severe stenosis were higher than those of patients with mild and moderate stenosis,and the serum Lp(a)levels of patients with moderate stenosis were higher than those of patients with mild stenosis,and the differences were statistically significant(P<0.05).The serum Lp(a)level in patients with endometrial thickening was(159.21±24.20)mg/L,lower than that in patients with plaque formation(248.53±46.00)mg/L;the serum Lp(a)level in patients with unstable plaques was(384.27±69.63)mg/L,higher than that in patients with stable plaques(134.02±25.14)mg/L,and the differences were statistically significant(P<0.05).The area under the curve(AUC)value of the Lp(a)receiver operator characteristic(ROC)curve was 0.993(95%CI 0.983-1.000)(P<0.05).Conclusion The higher the serum Lp(a)level,the more severe the carotid artery stenosis,the more likely plaques are to appear,and the higher the plaque instability.It has a high diagnostic efficiency for carotid atherosclerotic cerebral infarction,which should be paid attention to clinically.
作者
吴昌松
郑江环
王晋星一
顾雄先
孔义华
WU Changsong;ZHENG Jianghuan;WANG Jinxingyi;GU Xiongxian;KONG Yihua(Department of Neurology,the Second Affiliated Hospital of Guizhou Medical University,Kaili Guizhou 556000,China)
出处
《中国卫生标准管理》
2025年第14期111-114,共4页
China Health Standard Management
基金
2025年度贵州省卫生健康委员会科学技术基金项目(gzwkj2025-204)
贵州省黔东南州科技局计划项目(黔东南科合J字【2023】75号)。
关键词
颈动脉粥样硬化
脑梗死
脂蛋白(a)
狭窄程度
斑块性质
诊断效能
carotid atherosclerosis
cerebral infarction
lipoprotein(a)
stenosis degree
plaque characteristic
diagnostic efficiency
