血清脂蛋白相关磷脂酶A_2与冠状动脉粥样硬化斑块稳定性的相关研究——附107例报告  

Correlation between lipoprotein-associated phospholipase A_2 and the stability of coronary artery atherosclerotic plaque

作　　者：刘军妮[1] 徐冬玲[1] 杜贻萌[1] 姚桂华[1] 蒋卫东[1] 赵敬杰[1] 董兆强[1] 隋树建[1] 王欣[1] 鹿庆华[1] 

机构地区：[1]山东大学第二医院心内科,在读硕士研究生250033

出　　处：《新医学》2009年第1期18-20,46,共4页Journal of New Medicine

基　　金：2006年山东省科学科术发展计划资助项目(2006GG2202016)

摘　　要：目的:探讨血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)水平与冠状动脉粥样硬化斑块稳定性的关系。方法:对107例冠状动脉粥样硬化性心脏病(冠心病)患者行冠状动脉造影(coronary angiography,CAG)和血管内超声(in-travascular ultrasound,IVUS)检查,根据CAG和IVUS检查有无冠状动脉改变及斑块性质将患者分为稳定斑块组(38例)、不稳定斑块组(33例)和无斑块组(36例),检测所有患者血清的Lp-PLA2水平,分析血清Lp-PLA2水平与IVUS检查指标包括纤维帽厚度、偏心指数、重构指数的相关性。结果:稳定斑块组和不稳定斑块组的血清Lp-PLA2水平明显高于无斑块组(P<0.05);不稳定斑块组的血清Lp-PLA2高于稳定斑块组(P<0.05)。血清Lp-PLA2与斑块纤维帽厚度无明显相关性(r=-0.31,P(0.05),但与偏心指数和重构指数呈正相关(r=0.79,P<0.01;r=0.62,P<0.05)。结论:冠心病患者血清Lp-PLA2水平与冠状动脉粥样硬化斑块稳定性有关,可作为临床预测不稳定斑块的血清学指标。Objective ： To investigate the correlation between serum levels of lipoprotein-associated phospholipase A2 （Lp-PLA2 ） and the stability of coronary artery atheroselerotic plaques. Methods： One hundred and seven patients with coronary artery atherosclerotie heart disease were examined by coronary angiography （CAG） and intravaseular ultrasound （IVUS）. According to the coronary artery changes and plaque characters in CAG and IVUS, all patients were divided into stable plaque group （n = 38 ） , unstable plaque group （n = 33 ） and nonplaque group （n = 36 ）. The serum levels of Lp-PLA2 was measured in all patients, and the correlation of serum Lp-PLA2 and IVUS results such as fibrous cap thickness, eccentricity index and remodeling index were analyzed. Results： Serum levels of Lp-PLA2 in stable plaque group and unstable plaque group were significantly higher than that in non-plaque group （ P 〈 0. 05 ）. Serum levels of Lp-PLA2 in unstable plaque group was significantly higher than that in stable plaque group （ P 〈 0. 05 ）. There was no correlation between serum levels of Lp-PLA2 and the fibrous cap thickness （ r = - 0. 31, P 〉 0. 05 ） , however there was positive correlations between serum levels of Lp-PLA2 and eccentricity index and remodeling index （ r = 0. 79, P 〈 0. 01, r = 0. 62, P 〈 0. 05 ）. Conclusion： In coronary artery atherosclerotic heart disease patient, the serum levels of Lp-PLA2 is correlation to the stability of coronary artery atherosclerotie plaque, it may be used as a new serum index to predict the unstable plaque.

关 键 词：冠状动脉粥样硬化性心脏病 脂蛋白相关磷脂酶A2 冠状动脉造影 血管内超声 偏心指数 重构指数 

分 类 号：R541.4[医药卫生—心血管疾病] R743.33[医药卫生—内科学]