Relationship between MES,LP-PLA2,VCAM-1 and carotid atherosclerosis in patients with cerebral infarction

GAO Qiaolin; FENG Ting; ZHANG Hong; QIAO Zimei; LIANG Jiajia

Abstract：Objective To analyze the relationship between detection rate of microembolic signal(MES),serum lipoprotein-associated phospholipase A2(LP-PLA2),vascular cell adhesion molecule-1(VCAM-1)and carotid atherosclerosis(CAS)in patients with cerebral infarction.Methods 180 patients with acute cerebral infarction(ACI)admitted to the First Hospital of Yulin from June 2021 to June 2024 were selected as the research subjects.According to the carotid intima-media thickness of carotid ultrasound,they were divided into plaque formation group(n=70),intima thickening group(n=58)and normal intima group(n=52),and their clinical data were analyzed.120 healthy people admitted to the hospital for physical examination during the same period were included as the control group.The detection rate of MES and levels of serum LP-PLA2 and VCAM-1 were compared between ACI patients and the control group.The correlation between serum LP-PLA2 and VCAM-1 levels and clinical data was analyzed.Logistic regression analysis was used to analyze the influencing factors of CAS plaque formation in ACI patients.ROC curve was used to analyze the diagnostic value of MES,LP-PLA2 and VCAM-1 on CAS plaque formation.Results There were statistical differences in TC,TG,HDL-C and LDL-C among plaque formation group,intima thickening group and normal intima group(P＜0.05).The detection rate of MES and levels of serum LP-PLA2 and VCAM-1 in ACI group were higher than those in control group(P＜0.05),and significant differences were observed in the detection rate of MES,serum LP-PLA2 and VCAM-1 among plaque formation group,intima thickening group and normal intima group(P＜0.05).Pearson correlation analysis suggested that LP-PLA2 and VCAM-1 were positively correlated with TC,TG and LDL-C(P＜0.05),and were negatively correlated with HDL-C(P＜0.05).Binary logistic regression analysis showed that HDL-C,LDL-C,MES detection rate,serum LP-PLA2 and VCAM-1 were related to CAS plaque formation in ACI patients(P＜0.05).The detection rate of MES,serum LP-PLA2 and VCAM-1 were used as test variables,and ROC curve results revealed that the areas under the ROC curves of MES,LP-PLA2,VCAM-1 and combined detection for CAS plaque diagnosis were 0.806,0.797,0.783,and 0.921,and the sensitivities were 85.71%,81.43%,77.14%,and 94.29%respectively.The sensitivity of combined detection was higher than that of the single index.Conclusions MES,LP-PLA2 and VCAM-1 are the influencing factors of CAS formation,and combined detection can be used to assist the diagnosis of CAS formation in ACI patients.