血清CTRP12、Lp-PLA2在急性脑梗死患者中的表达及其与颈动脉粥样硬化的关系

doi:10.3969/j.issn.1004-583X.2026.01.005

摘要/Abstract

摘要：

目的观察急性脑梗死(acute cerebral infarction,ACI)患者血清补体C1q/肿瘤坏死因子相关蛋白-12(C1q/tumor necrosis factor-related protein 12,CTRP12)、脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)的表达,并分析其与颈动脉粥样硬化的关系。方法 2022年4月-2025年4月平顶山市第二人民医院收治172例ACI患者,剔除7例脱落病例后,共纳入165例。根据颈动脉内-中膜厚度分为内膜正常组(50例)、增厚组(54例)、斑块组(61例)。采用Spearman等级相关系数分析ACI患者血清CTRP12、Lp-PLA2水平与颈动脉粥样硬化的相关性;构建受试者工作特征曲线分析预测价值。结果血清CTRP12水平在斑块组、增厚组及内膜正常组中依次升高,而Lp-PLA2水平则依次降低(P<0.05);ACI患者颈动脉粥样硬化程度与血清CTRP12水平存在负相关关系,与血清Lp-PLA2水平存在正相关关系(P<0.05);经受试者工作特征曲线分析,血清CTRP12、Lp-PLA2水平单独及联合评估ACI患者斑块形成的曲线下面积为0.859、0.809、0.911,敏感度为0.852、0.803、0.885,特异度为0.817、0.788、0.865(P<0.05)。结论 ACI患者血清CTRP12、Lp-PLA2水平与其颈动脉粥样硬化密切相关,两项指标可作为评估斑块形成的生物学指标。

关键词: 急性脑梗死, 颈动脉粥样硬化, C1q/肿瘤坏死因子相关蛋白-12, 脂蛋白相关磷脂酶A2, 相关性

Abstract:

Objective To detect serum levels of C1q/ tumor necrosis factor-related protein-12 (CTRP12) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with acute cerebral infarction (ACI), and to analyze their relationship with carotid atherosclerosis. Methods From April 2022 to April 2025, 172 ACI patients admitted to the Second People's Hospital of Pingdingshan were selected. After excluding 7 dropouts, a total of 165 patients were included. According to the intima-media thickness (IMT) of the carotid artery, ACI patients were divided into the normal intima group (50 cases), the thickened intima group (54 cases), and the plaque group (61 cases). The Spearman rank correlation coefficient was used to analyze the correlation of serum levels of CTRP12 and Lp-PLA2 with carotid atherosclerosis in ACI patients. The receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value. Results The lowest serum CTRP12 was detected in the plaque group, followed by the thickened intima group and normal intima group. The highest serum Lp-PLA2 was detected in the plaque group, followed by the thickened intima group and normal intima group (P<0.05). The degree of carotid atherosclerosis in ACI patients was negatively correlated with serum CTRP12 and positively correlated with serum Lp-PLA2 (P<0.05). By ROC analysis, the areas under the curve for evaluating plaque formation in ACI patients by serum CTRP12 and Lp-PLA2 levels alone and in combination were 0.859, 0.809, and 0.911; the sensitivities were 0.852, 0.803, and 0.885; and the specificities were 0.817, 0.788, and 0.865, respectively (P<0.05). Conclusion Serum CTRP12 and Lp-PLA2 in ACI patients are closely related to their carotid atherosclerosis, and the two indicators can be used as biological indicators for evaluating plaque formation.

Key words: acute cerebral infarction, carotid atherosclerosis, C1q/tumor necrosis factor-related protein-12, lipoprotein-associated phospholipase A2, relevance

中图分类号:

R743.3

姬如意, 赵礼荣, 刘沙. 血清CTRP12、Lp-PLA2在急性脑梗死患者中的表达及其与颈动脉粥样硬化的关系[J]. 临床荟萃, 2026, 41(1): 33-37.

Ji Ruyi, Zhao Lirong, Liu Sha. Serum levels of CTRP12 and Lp-PLA2 in patients with acute cerebral infarction and their relationship with carotid atherosclerosis[J]. Clinical Focus, 2026, 41(1): 33-37.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.01.005

https://www.lchc.cn/CN/Y2026/V41/I1/33

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参考文献 24

[1]	崔娜, 王小刚, 董磊. 动脉粥样硬化型急性脑梗死患者颈动脉斑块特征及炎症因子与患者神经功能缺损程度的关系[J]. 中国医刊, 2024, 59(1):105-108.doi:10.3969/j.issn.1008-1070.2024.01.027.
[2]	李培卓, 梁瑞, 王丹瑞, 等. 急性脑梗死患者血清SAA、Hcy及MPO与颈动脉粥样硬化的相关性分析[J]. 成都医学院学报, 2025, 20(3):452-455, 460.doi:10.3969/j.issn.1674-2257.2025.03.020.
[3]	Liang L, Chen J, Zhang C, et al. Serum lipoprotein-associated phospholipase A2 level is positively correlated with the recurrence risk of acute ischemic cerebral infarction in hypertensive patients[J]. Nan Fang Yi Ke Da Xue Xue Bao, 2023, 43(2):317-322.doi: 10.12122/j.issn.1673-4254.2023.02.22.
[4]	柴凤霞, 唐丽华, 王磊. Lp-PLA2和hs-CRP在动脉粥样硬化评估中的应用[J]. 检验医学, 2022, 37(8):798-799. doi:10.3969/j.issn.1673-8640.2022.08.018.
[5]	孙翠梅, 王莹, 姜宏, 等. 急性前循环脑梗死患者血浆脂蛋白相关磷脂酶A2活性与颈内动脉狭窄的关系[J]. 临床神经病学杂志, 2021, 34(1):28-31.doi:10.3969/j.issn.1004-1648.2021.01.008.
[6]	董兰真, 孙学瑞, 吴婧, 等. 血清LP-PLA2和MMP-9水平与2型糖尿病合并脑梗死患者颈动脉斑块易损性的相关性[J]. 临床和实验医学杂志, 2024, 23(18):1916-1920.doi:10.3969/j.issn.1671-4695.2024.18.004.
[7]	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51(9):666-682.doi:10.3760/cma.j.issn.1006-7876.2018.09.004.
[8]	张晓玲, 黄莹芝. 2型糖尿病患者血清C1q/肿瘤坏死因子相关蛋白12水平与颈动脉粥样硬化相关性的研究[J]. 中国糖尿病杂志, 2025, 33(2):109-113.doi:10.3969/j.issn.1006-6187.2025.02.006.
[9]	陆怡德, 吴佳宁, 彭奕冰. 血清Lp-PLA2水平在急性缺血性脑卒中患者中的临床应用[J]. 检验医学, 2020, 35(2):129-133.doi:10.3969/j.issn.1673-8640.2020.02.008.
[10]	于海艳, 任晓晓. 急性缺血性脑卒中患者血清成纤维细胞生长因子21、C1q肿瘤坏死因子相关蛋白12水平及其预后价值[J]. 内科急危重症杂志, 2025, 31(1):62-64, 71.doi:10.11768/nkjwzzzz20250111.
[11]	桂琳, 董睿, 吴雪莲, 等. 补体C1q/肿瘤坏死因子相关蛋白家族在动脉粥样硬化中的作用[J]. 心血管病学进展, 2024, 45(6):552-556.doi:10.16806/j.cnki.issn.1004-3934.2024.06.017.
[12]	林洁, 王爱华. Lp-PLA2对颅内外动脉粥样硬化性狭窄的预测价值[J]. 神经疾病与精神卫生, 2023, 23(8):544-549.doi:10.3969/j.issn.1009-6574.2023.08.003.
[13]	孙跃, 李志, 张钧, 等. 血清CTRP5、CTRP12、CTRP13与老年2型糖尿病患者糖脂代谢和颈动脉粥样硬化的关系[J]. 现代生物医学进展, 2024, 24(9):1760-1766.doi:10.13241/j.cnki.pmb.2024.09.032.
[14]	刘效荣, 张旋, 徐萌, 等. 初诊2型糖尿病合并动脉粥样硬化患者血清CTRP12表达及其机制研究[J]. 中国医师杂志, 2019, 21(7):1048-1050.doi:10.3760/cma.j.issn.1008-1372.2019.07.020.
[15]	刘曙光, 赵岩. 急性脑梗死患者CD62p Lp-PLA2与早期神经功能恢复的相关性[J]. 中国实用神经疾病杂志, 2025, 28(3):321-325.doi:10.12083/SYSJ.240945.
[16]	王秀杰, 赵晓晶, 李敏, 等. Lp-PLA2、sTfR、P2X7R水平与急性脑梗死患者静脉溶栓后认知功能及预后不良的关系[J]. 实用心脑肺血管病杂志, 2025, 33(1):61-66.doi:10.12114/j.issn.1008-5971.2024.00.303.
[17]	禹萌, 任雅芳, 王煜姝, 等. 急性脑梗死患者血清中CyPA、Lp-PLA2含量与动脉粥样硬化、神经损伤的相关性[J]. 中国现代医学杂志, 2018, 28(16):44-47.doi:10.3969/j.issn.1005-8982.2018.16.009.
[18]	秦瑞丹, 张娟, 梁营营, 等. 原发性高血压患者血浆致动脉粥样硬化指数及血清脂蛋白相关磷脂酶A2水平与左心室肥厚的关系研究[J]. 中国全科医学, 2024, 27(27):3359-3364.doi:10.12114/j.issn.1007-9572.2023.0804.
[19]	赵宁博, 王昌铭. 血清SAA、LP-PLA2、Tau及ChE与脑梗死后血管性认知障碍相关研究[J]. 标记免疫分析与临床, 2025, 32(4):792-798, 880.doi:10.11748/bjmy.issn.1006-1703.2025.04.026.
[20]	刘宏娜, 李晓宇, 宋爱霞, 等. 急性脑梗死患者血清CTRP3及CTRP9水平与颈总动脉内膜中层厚度的相关性分析[J]. 临床和实验医学杂志, 2024, 23(11):1153-1156.doi:10.3969/j.issn.1671-4695.2024.11.009.
[21]	左玮玮, 郭泓江. 颈动脉CTA评估颈动脉粥样硬化狭窄程度及与血清脂蛋白相关磷脂酶A2、血管生成素样蛋白8水平的相关性分析[J]. 陕西医学杂志, 2025, 54(1):62-66.doi:10.3969/j.issn.1000-7377.2025.01.011.
[22]	Liu A, Liu X, Zhang J, et al. Efficacy of butylphthalein injection combined with alteplase thrombolysis in patients with acute cerebral infarction and its impact on Lp-PLA2 and CXCL16 levels[J]. Am J Transl Res, 2024, 16(12):8054-8062.doi: 10.62347/EIPN6922.eCollection2024.
[23]	廖晶威, 许佳恒, 何毅, 等. 三维超声联合Lp-PLA2与Resistin评估脑梗死患者颈动脉斑块稳定性[J]. 中国超声医学杂志, 2025, 41(1):8-12.doi:10.3969/j.issn.1002-0101.2025.01.003.
[24]	郭根心, 成宏兵. 血清脂蛋白相关磷脂酶A2联合同型半胱氨酸对老年冠心病患者下肢动脉粥样硬化疾病的诊断价值研究[J]. 实用心脑肺血管病杂志, 2021, 29(1):15-20.doi:10.12114/j.issn.1008-5971.2021.01.004.

组别	例数	男/女 (例)	年龄 (岁)	病程 (h)	糖尿病 [例(%)]	高血压 [例(%)]	饮酒史 [例(%)]	吸烟史 [例(%)]
内膜正常组	50	28/22	62.91±8.14	13.17±4.26	6(12.00)	10(20.00)	7(14.00)	9(18.00)
增厚组	54	30/24	63.07±7.59	12.94±3.06	9(16.67)	14(25.93)	11(20.37)	14(25.93)
斑块组	61	35/26	63.52±7.86	13.68±3.52	8(13.11)	17(27.87)	12(19.67)	16(26.23)
χ²/F值		0.043	0.092	0.632	0.526	0.961	0.853	1.264
P值		0.979	0.912	0.533	0.769	0.618	0.653	0.531

组别	例数	男/女 (例)	年龄 (岁)	病程 (h)	糖尿病 [例(%)]	高血压 [例(%)]	饮酒史 [例(%)]	吸烟史 [例(%)]
内膜正常组	50	28/22	62.91±8.14	13.17±4.26	6(12.00)	10(20.00)	7(14.00)	9(18.00)
增厚组	54	30/24	63.07±7.59	12.94±3.06	9(16.67)	14(25.93)	11(20.37)	14(25.93)
斑块组	61	35/26	63.52±7.86	13.68±3.52	8(13.11)	17(27.87)	12(19.67)	16(26.23)
χ²/F值		0.043	0.092	0.632	0.526	0.961	0.853	1.264
P值		0.979	0.912	0.533	0.769	0.618	0.653	0.531

组别	例数	CTRP12(ng/L)	Lp-PLA2(μg/L)
内膜正常组	50	427.64±136.59	242.37±19.65
增厚组	54	275.81±84.05^*	263.68±22.54^*
斑块组	61	206.31±65.42^*#	287.94±25.16^*#
F值		72.288	55.624
P值		0.000	0.000

组别	例数	CTRP12(ng/L)	Lp-PLA2(μg/L)
内膜正常组	50	427.64±136.59	242.37±19.65
增厚组	54	275.81±84.05^*	263.68±22.54^*
斑块组	61	206.31±65.42^*#	287.94±25.16^*#
F值		72.288	55.624
P值		0.000	0.000

指标	r值	P值
CTRP12	-0.576	0.009
Lp-PLA2	0.513	0.012