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中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (6): 684-688.

• 药物治疗学 • 上一篇    下一篇

动脉粥样硬化性缺血性脑卒中患者血浆中TMAO与Lp-PLA2水平的相关性研究

刘振东1,郑 宁2   

  1. 1绍兴市中心医院十三西病区,绍兴 312002,浙江; 2金华市人民医院超声科,金华 321000,浙江
  • 收稿日期:2016-11-14 修回日期:2017-01-05 出版日期:2017-06-26 发布日期:2017-06-26
  • 通讯作者: 浙江省医药卫生研究计划(2012KYA180)
  • 作者简介:刘振东,男,硕士,副主任医师,研究方向:脑血管疾病。 Tel:18142027320 E-mail:ddu1101@163.com
  • 基金资助:

    浙江省医药卫生研究计划(2012KYA180)

Correlation of TMAO and Lp-PLA2 levels in patients with atherosclerotic ischemic stroke

LIU Zhengdong 1, ZHENG Ning 2   

  1. 1 13th Ward, Shaoxing Central Hospital, Shaoxing 312002, Zhejiang, China; 2 Ultrasound Department of Jinhua People's Hospital, Jinhua 321000, Zhejiang, China
  • Received:2016-11-14 Revised:2017-01-05 Online:2017-06-26 Published:2017-06-26

摘要:

目的: 探讨动脉粥样硬化性缺血性脑卒中患者血浆中氧化三甲胺(TMAO)与脂蛋白相关磷脂酶(Lp-PLA2)水平的相关性。方法: 选择发病72 h内的动脉粥样硬化性缺血性脑卒中患者80例为病例组,同时选取门诊健康体检者40例为对照组,采用彩色多普勒超声检测颈动脉粥样硬化严重程度;采用酶联免疫法(ELISA)检测血清TMAO与Lp-PLA2水平,采用日立7180全自动生化分析仪检测血脂。对比分析两组TMAO、Lp-PLA2水平及血脂差异和相关性。结果: 病例组血清TMAO、Lp-PLA2水平明显高于对照组,差异有统计学意义(P<0.05);病例组患者血浆TMAO与Lp-PLA2呈正相关(r=0.745,P<0.05),TMAO、Lp-PLA2与三酯甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等血脂指标无明显相关性(P>0.05);颈动脉重度狭窄组的TMAO、Lp-PLA2水平高于中度组和轻度组(P<0.01);TMAO水平与颈动脉狭窄程度呈正相关(rs=0.763,P<0.01),Lp-PLA2水平与颈动脉狭窄程度呈正相关(rs=0.732,P<0.01)。结论: TMAO、Lp-PLA2参与了动脉粥样硬化性缺血性脑卒中的发病过程,颈动脉粥样硬化严重程度不同的缺血性脑卒中患者TMAO、Lp-PLA2水平不同,TMAO、Lp-PLA2可能是动脉粥样硬化性缺血性脑卒中的一个潜在血清标志物。

关键词: 动脉粥样硬化, 缺血性脑卒中, 氧化三甲胺, 脂蛋白相关磷脂酶

Abstract:

AIM: To investigate the correlation between TMAO and Lp-PLA2 levels in patients with atherosclerotic ischemic stroke.  METHODS: Eighty patients with atherosclerotic ischemic stroke within 72 hours were selected as the case group, and another 40 healthy subjects were selected as the control group. The severity of carotid atherosclerosis was detected by color Doppler ultrasound. Serum TMAO and Lp-PLA2 were detected by enzyme-linked immunosorbent assay (ELISA). Blood lipids were detected by Hitachi 7180 automatic biochemical analyzer. Levels of TMAO, Lp-PLA2 as well as the differences and correlations of blood lipids between the two groups were compared. RESULTS: The serum levels of TMAO and Lp-PLA2 were significantly higher than those of the control group (P<0.05). There was a positive correlation between TMAO and Lp-PLA2 (r=0.745,P<0.01). Lp-PLA2 showed no significant correlation with TC, TG, HDL-C and LDL-C (P>0.05). Levels of TMAO and Lp-PLA2 in carotid stenosis group were higher than those in moderate group and mild group (rs=0.763,P﹤0.01). There was a positive correlation between the level of TMAO and carotid artery stenosis (rs=0.732,P<0.01). CONCLUSION: Levels of TMAO and Lp-PLA2 in ischemic stroke patients with different severity of carotid atherosclerosis are different. TMAO and Lp-PLA2 are involved in the pathogenesis of atherosclerotic ischemic stroke, which may be a potential serum marker of atherosclerotic ischemic stroke.

Key words: atherosclerosis, ischemic stroke, trimethylamine oxide, lipoprotein-related phospholipase

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