JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (3): 112-116.doi: 10.6040/j.issn.1671-7554.0.2016.1006

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Diagnostic value of the level of plasma lipoprotein-associated phospholipase A2 and the CEU degree of neovascularization of carotid artery plaque in acute cerebral infarction

ZHANG Yunhua1,2, LI Jie1   

  1. 1. Department of Ultrasound, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Ultrasound, Liaocheng Third Peoples Hospital, Liaocheng 252000, Shandong, China
  • Received:2016-08-17 Online:2017-03-10 Published:2017-03-10

Abstract: Objective To detect the value of plasma lipoprotein-associated phospholipase A2(Lp-PLA2)and the contrast-enhanced untrasonography(CEU)degree of neovascularization of carotid artery plaque in diagnosis of acute cerebral infarction(ACI). Methods A total of 44 patients with ACI(ACI group)and 41 patients without ACI(non-ACI group)were selected. The enrolled patients underwent conventional and CEU. The development intensity of neovascularization was observed and classified. The plasma Lp-PLA2 levels were detected by double antibody sandwich immunochromatography assay. Results There was significant difference between ACI group and non-ACI group in the grade of neovascularization of carotid plaques(Z=-5.29, P<0.01). The grade of neovascularization in ACI group was mostly Ⅲ and Ⅳ(median Ⅲ)and that of non-ACI group was mostly Ⅰ and Ⅱ(median Ⅱ). The plasma Lp-PLA2 levels in ACI group were significantly higher than those in non ACI group(t=6.64, P<0.001). With cutoff value 199.76 μg/L, the sensitivity, specificity, and area under the curve(AUC)were 84%, 68%, and 0.84, respectively. The higher the grade of neovascularization of carotid plaque, the higher the levels of plasma Lp-PLA2(rs=0.60, P<0.001), and there 山 东 大 学 学 报 (医 学 版)55卷3期 -张云华,等.颈动脉斑块内新生血管显影程度及血浆Lp-PLA2水平对急性脑梗死的临床诊断价值 \=-was a positive correlation between them. Conclusion As a noninvasive method, CEU can be used to observe neovascularization of carotid plaque in real time, and make a quantitative analysis. The higher grade of neovascularization of carotid plaque and the higher levels of the plasma Lp-PLA2 may be valuable for clinical diagnosis of ACI.

Key words: Carotid artery plaque, Neovascularization, Contrast-enhanced untrasonography, Lipoprotein-associated phospholipase A2, Acute cerebral infarction

CLC Number: 

  • R445.1
[1] 贾建平, 陈生弟. 神经病学(7版)[M]. 北京: 人民卫生出版社, 2013: 192-221.
[2] Skarpathiotakis M, Mandell DM, Swartz RH, et al. Intracranial atherosclerotic plaque enhancement in patients with ischemic stroke[J]. AJNR Am J Neuroradiol, 2013, 34(2): 299-304.
[3] Chang X, Feng J, Ruan L, et al. Positive correlation between neovascularization degree of carotid atherosclerosis determined by contrast-enhanced ultrasound and level of serum C-reactive protein[J]. Vasa, 2015, 44(3): 187-194.
[4] Rosenson RS, Stafforini DM. Modulation of oxidative stress, inflammation, and atherosclerosis by lipoprotein-associated phospholipase A2[J]. J Lipid Res, 2012, 53(9): 1767-1782.
[5] 中华医学会神经病学分会. 中国急性缺血性脑卒中诊治指南2014[J]. 中华神经科杂志, 2015, 48(4): 246-257.
[6] 朱英, 邓又斌, 刘娅妮, 等. 超声造影评价颈动脉粥样硬化斑块的新生血管与冠心病的关系[J]. 中华超声影像学杂志, 2013, 19(8): 670-673. ZHU Ying, DENG Youbin, LIU Yani, et al. Evaluation of the relationship between carotid plaque instability and coronary heart disease by contrast-enhanced ultrasound[J]. Chinese J Ultrasonogr, 2013, 19(8): 670-673.
[7] 朱玉萍, 赵晓辉, 周媛, 等. 不同类型脑白质疏松与颈动脉粥样硬化斑块稳定性和血清脂蛋白相关磷脂酶A2的相关性[J]. 中国动脉硬化杂志, 2014, 22(7): 706-710. ZHU Yuping, ZHAO Xiaohui, ZHOU Yuan, et al. Relationship between different kinds of leukoaraiosis, stability of carotid atherosclerosis plaque and serum Lp-PLA2 [J]. Chin J Arterioscler, 2014, 22(7): 706-710.
[8] Zhang Q, Li C, Han H, et al. Spatio-temporal quantification of carotid plaque neovascularization on contrast enhanced ultrasound: correlation with visual grading and histopathology[J]. Eur J Vasc Endovasc Surg, 2015, 50(3): 289-296.
[9] Sun XF, Wang J, Wu XL, et al. Evaluation of the stability of carotid atherosclerotic plaque with contrast-enhanced ultrasound[J]. J Med Ultrason, 2016, 43(1): 71-76.
[10] Hingwala D, Kesavadas C, Sylaja PN, et al. Multimodality imaging of carotid atherosclerotic plaque: Going beyond stenosis[J]. Indian J Radiol Imaging, 2013, 23(1): 26-34.
[11] Potente M, Gerhardt H, Carmeliet P. Basic and therapeutic aspects of angiogenesis[J]. Cell, 2011, 146(6): 873-887.
[12] Sun J, Liu K, Tang QY, et al. Correlation between enhanced intensity of atherosclerotic plaque at contrast-enhanced ultrasonography and density of histological neovascularization[J]. J Huazhong Univ Sci Technolog Med Sci, 2013, 33(3): 443-446.
[13] 李超伦, 王文平, 何婉媛, 等. 超声造影评价颈动脉斑块内新生血管形成与临床症状的关系[J]. 中国超声医学杂志(电子版), 2011, 27(11): 991-994. LI Chaolun, WANG Wenping, HE Wanyuan, et al. Correlation of carotid artery plaque echogenicity with intraplaque neovascularization detected with contrast-enhanced ultrasound[J]. Chin J Med Ultrasound(Electronic Edition), 2011, 27(11): 991-994.
[14] 郗扬. 斑块内新生血管的作用及应对[J]. 国际心血管病杂志, 2014, 41(1): 14-17.
[15] Kurata M, Nose M, Shimazu Y, et al. Microvasculature of carotid atheromatous plaques: hemorrhagic plaques have dense microvessels with fenestrations to the arterial lumen[J]. J Stroke Cerebrovasc Dis, 2014, 23(6):1440-1446.
[16] Lin J, Zheng H, Cucchiara BL, et al. Association of Lp-PLA2-A and early recurrence of vascular events after TIA and minor stroke[J]. Neurology, 2015, 85(18): 1585-1591.
[17] Lavi S, McConnell JP, Rihal CS, et al. Local production of lipoprotein-associated phospholipase A2 and lysophosphatidylcholine in the coronary circulation: association with early coronary atherosclerosis and endothelial dysfunction in humans[J]. Circulation, 2007, 115(21): 2715-2721.
[18] Macphee CH, Nelson J, Zalewski A. Role of lipoprotein-associated phospholipase A2 in atherosclerosis and its potential as a therapeutic target[J]. Curr Opin Pharmacol, 2006, 6(2): 154-161.
[19] Tuttolomondo A, Di Raimondo D, Pecoraro R, et al. Atherosclerosis as an inflammatory disease[J]. Curr Pharm Des, 2012, 18(28): 4266-4288.
[20] Sluimer JC, Daemen MJ. Novel concepts in atherogenesis: angiogenesis and hypoxia in atherogenesis[J]. J Pthol, 2009, 218(1): 7-29.
[21] Ait-Oufella H, Mallat Z, Tedgui A. Lp-PLA2 and sPLA2: cardiovascular biomarkers[J]. Med Sci(Paris), 2014, 30(5): 526-531.
[22] Carmi Y, Voronov E, Dotan S, et al. The role of macrophage-derived IL-1 in induction and maintenance of angiogenesis[J]. J Immunol, 2009, 183(7): 4705-4714.
[23] Varetto G, Gibello L, Bergamasco L, et al. Contrast enhanced ultrasound in atherosclerotic carotid artery disease[J]. Int Angiol, 2012, 31(6): 565-571.
[24] Van Hinsbergh VW, Eringa EC, Daemen MJ. Neovascularization of the atherosclerotic plaque: interplay between atherosclerotic lesion, adventitia-derived microvessels and perivascular fat[J]. Curr Opin Lipidol. 2015, 26(5):405-411.
[25] 赵雅萍, 邹春鹏, 孙晶, 等. 超声造影三维成像评价颈动脉软板块内新生血管的初步研究[J]. 中华超声影像学杂志, 2010, 19(11): 937-939. ZHAO Yaping, ZOU Chunpeng, SUN Jing, et al. Preliminary study on evaluation of neovascularization within carotid soft plaques with contrast-enhanced three dimensional ultrasonography[J]. Chinese J Ultrasound Med, 2010, 19(11): 937-939.
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