脂蛋白相关磷脂酶与冠状动脉易损斑块的相关性  

The correlation of human serum Lp-PLA2 and hs-CRP and stability of coronary atilerosclerotic plaques

作　　者：徐冬玲[1] 刘军妮[1] 杜贻萌[1] 姚桂华[2] 蒋卫东[1] 王欣[1] 董兆强[1] 郝琳[1] 王光允[1] 隋树建[1] 李继福[2] 鹿庆华[1] 

机构地区：[1]山东大学第二医院心内科,济南250033 [2]山东大学齐鲁医院心内科

出　　处：《中华内科杂志》2009年第8期651-654,共4页Chinese Journal of Internal Medicine

基　　金：山东省科学技术发展计划（2006GG2202016）

摘　　要：目的探讨冠心病患者血清脂蛋白相关磷脂酶A2（Lp-PLA2）及超敏C反应蛋白（hs—CRP）水平与冠状动脉粥样硬化易损斑块的相关性。方法对入院行冠状动脉造影（CAG）患者同时行血管内超声（IVUS）检查，依据CAG和IVUS检查结果，将患者分为对照组、稳定斑块组和易损斑块组。患者术前取空腹静脉血，监测血清Lp-PLA2、hs—CRP水平，并行相关分析。结果（1）血清Lp-PLA2水平在稳定斑块组和易损斑块组明显高于对照组（P〈0．05）。（2）血清Lp．PLA2水平在易损斑块组高于稳定斑块组（P〈0．05）。（3）血清hs-CRP水平在易损斑块组高于稳定斑块组与对照组，两者之间差异有统计学意义（P〈0．05）。（4）血清Lp—PLA2辅助识别易损斑块特异性高于hs—CRP。结论与hs—CRP比较血清Lp—PLA2与冠状动脉粥样硬化易损斑块的IVUS指标相关性更好。血清Lp—PLA2与hs—CRP联合检测更能反映斑块的不稳定性，可作为临床预测易损斑块的血清学指标。Objective To explore the relationship of serum lipoprotein-associated phospholipase A2 and high sensitive C-reactive protein in vulnerable coronary atherosclerotic plaques. Methods Patients undergoing coronary angiography （CAG） were examined for CAD with intravascular ultrasound （IVUS）. According to the findings of CAG and IVUS, all the patients were divided into three groups： a control group without plaque, stable plaque group and vulnerable plaque group. The total serum Lp-PLA2 and hs-CRP were measured before angiography and they were valued with T test and Pearson＇s correlation analysis. Results （ 1 ） Lp-PLA2 level in stable plaque group and vulnerable plaque group was higher than that in control group （P 〈 0. 05）. （2） Lp-PLA2 level in the vulnerable plaque group was higher than that in stable plaque group （P 〈0. 05）. （3）hs-CRP level in the vulnerable plaque group is higher than that in the stable plaque group and control group （ P 〈 0. 05 ） and there was significant difference between them. （4） To discriminate vulnerable plaque, the specificity of serum Lp-PLA2 was stronger than that of hs-CRP. Conclusions Serum Lp-PLA2 level has higher sensitivity in predicting the vnlnerability of the coronary atherosclerotic plaque than hs-CRP. In combination with hs-CRP,we can use Lp-PLA2 as a new biomarker to predict the presence of vulnerable plaque.

关 键 词：冠状动脉疾病 脂蛋白类 C-反应蛋白 

分 类 号：R686[医药卫生—骨科学]