Objective To investigate the clinical significance of plasma lipoprotein-associated phospholipase A2 (LP-PLA2) determination in patients with ischemic cerebral stroke(ICS).Methods 124 patients with ICS (ICS group)admitted to Dongfeng Huaguo Hospital in Shiyan City from Jan.2011 to June.2014 and 50 patients with hemorrhagic stroke (hemor-rhagic group)were as the research objects,and 50 healthy controls at the same time were as the control group,compared the plasma Lp-PLA2 levels between the three groups,and compared carotid artery atherosclerotic plaque and plasma Lp-PLA2 levels in patients with different severity of ICS.Results The levels of plasma Lp-PLA2 of the patients of the ICS group,the hemorrhage group and the control group were 58.4±9.6 g/L,30.5±9.2 g/L and 18.7±8.3 g/L,respectively.There were significant differences between the groups (F = 16.741,P = 0.000).The level of plasma Lp-PLA2 of the patients of the plaque group was higher than that of the non-plaque group (66.3 ±9.7 g/L vs 54.1±10.3 g/L,t=5.775,P =0.000),and the unstable plaque group was higher than that of the stable plate group (72.4±9.5 g/L vs 62.8±10.1 g/L,t=4.797,P =0.000).The plasma Lp-PLA2 level of patients with light,medium,heavy ICS were 48.4± 9.2 g/L,60.9 ± 9.6 g/L and 74.5±10.3 g/L,respectively,and the difference was statistically significant between the three groups (F = 13.629,P =0.000).The plasma levels of Lp-PLA2 were positively correlated with NIHSS scores in patients with ICS (r=0.716,P <0.05).Lp-PLA2 in diagnosis of ICS area under the ROC curve was 0.904,the optimal critical value was 45.2 μg/L,the sen-sitivity and specificity were 81.5% and 80.2%.Conclusion The determination of plasma LP-PLA2 has a good effect in di-agnosis of ICS,the plasma level of ICS can be responsed the severity of the patients and the stability of atherosclerotic plaque.%目的：探讨血浆脂蛋白相关磷脂酶 A2（Lp-PLA2）测定在缺血性脑卒中（ICS）诊治中的价值。方法选择2011年1月～2014年6月期间十堰市东风花果医院124例 ICS 患者（ICS 组）、50例出血性脑卒中患者（出血组）作为研究对象，并选择同期体检者50例作为对照组，比较三组血浆 Lp-PLA2水平，并比较有无颈动脉粥样硬化斑块、不同病情 ICS 患者血浆 Lp-PLA2水平。结果ICS 组、出血组和对照组血浆 Lp-PLA2水平分别为58.4±9.6μg／L，30.5±9.2μg／L 和18.7±8.3μg／L，组间差异有统计学意义（F ＝16.741，P ＝0.000）；血浆 Lp-PLA2水平有斑块组高于无斑块组（66.3±9.7μg／L vs 54.1±10.3μg／L，t＝5.775，P ＝0.000），不稳定型斑块组高于稳定型斑块组（72.4±9.5μg／L vs 62.8±10.1μg／L，t＝4.797，P ＝0.000）；轻型、中型、重型 ICS 患者血浆 Lp-PLA2水 平 分 别 为48.4±9.2μg／L，60.9 ±9.6μg／L 和74.5±10.3μg／L，三组间差异有统计学意义（F ＝13.629，P ＝0.000），血浆 Lp-PLA2水平与 ICS 患者 NIHSS 评分呈正相关（r＝0.716，P ＜0.05）；Lp-PLA2诊断 ICS ROC 曲线下面积为0.904，最佳临界值为45.2μg／L，敏感度、特异度分别为81.5％和80.2％。结论血浆 LP-PLA2检测对 ICS 具有良好的诊断效能，其血浆水平可反应 ICS 患者病情程度和动脉粥样硬化斑块的稳定性。
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