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目的探讨脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2,Lp-PLA2)血清水平及其基因A379V多态性与低分子肝素实验病因分型(the trial of Org 10172 in acute stroke treatment,TOAST)的关系。方法对急性期脑梗死患者(N=200)和对照组(体检中心健康体检者,N=172)应用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清Lp-PLA2水平,聚合酶链反应(polymerasechain reaction,PCR)及基因测序技术检测基因多态性。结果脑梗死组血清Lp-PLA2水平(24.39±6.63)ng/ml,高于对照组(15.78±4.32)ng/ml,差异有显著性(P<0.01);TOAST分型后比较,大动脉粥样硬化性梗死(large artery atherosclerotic stroke,LAA)组、小动脉闭塞性梗死(small artery occlusion stroke,SAO)组、对照组血清Lp-PLA2水平分别是(25.60±6.71)ng/ml、(21.43±5.47)ng/ml、(15.78±4.32)ng/ml,差异有显著性(P<0.01);脑梗死组惠者,Lp-PLA2基因A379V多态性位点CC基因型频率68%,C等位基因频率83%,与对照组的70.9%、84.3%比较,差异无显著性(P>0.05),但是TOAST分型后显示CC纯合子血清Lp-PLA2水平(26.27±6.25)ng/ml较T等位基因携带者(CT+TT)(20.39±5.64)ng/ml发生脑梗死的风险增加(P<0.01)。结论 Lp-PLA2血清水平在脑梗死组升高,LAA组升高最明显;A379V基因多态性CC基因型与脑梗死的发病可能相关。
Objective To investigate the relationship between the level of lipoprotein associated phospholipase A2 (Lp-PLA2) and its gene A379V polymorphism and the trial of Orgin 10172 in acute stroke treatment (TOAST) . Methods Serum levels of Lp-PLA2 were detected by enzyme-linked immunosorbent assay (ELISA) in patients with acute cerebral infarction (N = 200) and control subjects (physical examination center, N = 172) (Polymerase chain reaction, PCR) and gene sequencing technology to detect genetic polymorphisms. Results Compared with the control group (15.78 ± 4.32) ng / ml, the level of Lp-PLA2 in the cerebral infarction group was significantly higher (24.39 ± 6.63) ng / ml Serum levels of Lp-PLA2 in the control group were (25.60 ± 6.71) ng / ml and (21.43 ± 5.47), respectively, in the LAA group and the SAO group (15.78 ± 4.32) ng / ml, the difference was significant (P <0.01). The frequency of CC genotype of A379V polymorphism in Lp-PLA2 gene was 68% (P> 0.05). However, the level of Lp-PLA2 in CC homozygous (26.27 ± 6.25) ng / ml was significantly higher than that in control group (P> 0.05) Allele carriers (CT + TT) (20.39 ± 5.64) ng / ml increased the risk of cerebral infarction (P <0.01). Conclusions The serum level of Lp-PLA2 is increased in cerebral infarction group and the most obvious increase in LAA group. The CC genotype of A379V gene may be related to the onset of cerebral infarction.