Predictive Value of Ratio of Monocytes to HDL Cholesterol and Lipoprotein-associated Phospholipase A2 for Carotid Plaque Instability
Objective:To investigate the predictive value of monocytes to HDL lipoprotein cholesterol ratio(MHR)and plasma lipoprotein-associated phospholipase A2(Lp-PLA2)in carotid plaque instability in patients with cerebral infarction.Methods:A retrospective analysis method was used to include 190 patients with first acute cerebral infarction who were treated in the Third Ward of the Department of Neurology,the First Affiliated Hospital of Xinxiang Medical College from January 2020 to January 2022.All participants underwent ultrasonography to know the carotid artery plaque situation,and according to the ultrasound results,they were divided into plaque-free group(50 cases),stable plaque group(42 cases),and unstable plaque group(98 cases).The automatic biochemical analyzer was used to detect relevant indicators,such as blood routine,blood lipids,plasma Lp-PLA2.The clinical baseline data and various indicators of each group were compared and analyzed.The independent risk factors for carotid artery plaque formation and instability were assessed by binary multivariate logistic regression analysis.Results:Compared with the plaque group,there were significant differences in age,smoking,LDL cholesterol,hypertension,monocyte count,Lp-PLA2 and MHR(P＜0.05).Logistic regression analysis showed that smoking,LDL cholesterol and MHR were independent risk factors for carotid plaque formation.Compared with the unstable plaque group,the differences in smoking,LDL cholesterol,monocytes,MHR,plasma Lp-PLA2 were statistically significant(P＜0.05).Logistic regression analysis showed that smoking,MHR and Lp-PLA2 were independent risk factors for carotid plaque instability.ROC analysis results of MHR prediction of carotid unstable plaque showed that AUC=0.787,95% CI=0.707～0.866,P＜0.05,sensitivity was 81.6%,and specificity was 61.9% .ROC curve analysis of Lp-PLA2 for predicting carotid unstable plaque showed that AUC=0.768,95% CI=0.689～0.847,P＜0.05,sensitivity was 79.6%,and specificity was 52.4% .Conclusion:Lp-PLA2 and MHR are independent risk factors for carotid plaque formation and plaque instability,and have good predictive value for plaque instability.Early intervention with high levels of Lp-PLA2 and MHR can reduce the incidence of cerebral infarction caused by plaque rupture.
万方数据
维普
