稳定型心绞痛患者血清可溶性凝集素样氧化型低密度脂蛋白受体1与冠状动脉复杂病变相关  

Serum Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Correlates with Coronary Lesion Complexity in Patients with Stable Angina

作　　者：祝雪丽[1,2] 赵子文[1,2] 方军[1,2] 蔡炜[1,2] 吴黎明[1,3] 陈良龙[1,2] 

机构地区：[1]福建医科大学附属协和医院心内科 [2]福建省冠心病研究所 [3]福建省老年医学研究所,福建省福州市350001

出　　处：《中国动脉硬化杂志》2010年第8期639-642,共4页Chinese Journal of Arteriosclerosis

基　　金：卫生部科学研究基金-福建卫生教育联合攻关计划项目(wkj2008-2-xx)

摘　　要：目的通过检测稳定型心绞痛患者血清可溶性凝集素样氧化型低密度脂蛋白受体1水平,探讨其与冠状动脉复杂病变的存在及病变严重程度的关系,明确血清可溶性凝集素样氧化型低密度脂蛋白受体1水平对稳定型心绞痛患者冠状动脉不稳定性斑块的预测及评估意义。方法纳入108例行冠状动脉造影检查的稳定型心绞痛患者,根据冠状动脉病变特征分为简单病变组（n=46）和复杂病变组（n=62）。采用Gensini评分系统评价冠状动脉病变的严重程度,酶联免疫吸附法检测所有患者血清可溶性凝集素样氧化型低密度脂蛋白受体1水平。结果复杂病变组血清可溶性凝集素样氧化型低密度脂蛋白受体1[1.12（0.34-1.68）μg/L]明显高于简单病变组[0.28（0.14-0.64）μg/L,P〈0.05]。多项二元Logistic回归分析显示,患者血清可溶性凝集素样氧化型低密度脂蛋白受体1是冠状动脉病变复杂性的独立预测因子（OR为2.99,95%CI为1.47-6.08,P=0.003）。Pearman相关分析显示,血清可溶性凝集素样氧化型低密度脂蛋白受体1对数值与Gensini评分对数值之间呈正相关关系（R=0.458,P〈0.05）。以1.10μg/L为临界值,血清可溶性凝集素样氧化型低密度脂蛋白受体1诊断稳定型心绞痛的敏感度为54.8%、特异度为93.5%（P〈0.05）。结论血清可溶性凝集素样氧化型低密度脂蛋白受体1的水平是稳定型心绞痛患者存在复杂病变的独立危险因子,它还可作为预测不稳定性斑块的血清学指标。同时,血清可溶性凝集素样氧化型低密度脂蛋白受体1水平也与稳定型心绞痛患者冠状动脉狭窄程度相关,可以作为判断预后的指标用于临床。Aim To assess whether levels of serum soluble lectin-like oxidized low-density lipoprotein receptor-1（sLOX-1） are correlated with angiographic coronary lesion complexity in patients with stable angina pectoris（SAP）,and evaluate the value of sLOX-1 in early prediction of the vulnerable coronary atherosclerotic plaque. Methods Levels of sLOX-1 were measured in 108 stable angina pectoris patients（46 with simple coronary lesions and 62 with complex coronary lesions）.Coronary lesions were classified as of simple or complex appearance.Gensini score system was used to measure the severity of coronary artery disease;Enzyme-linked immunosorbent assay（ELISA）was used to measure sLOX-1 levels. Results sLOX-1 levels were significantly higher in stable angina pectoris patients with complex coronary lesions1.12（0.34～1.68） μg/L,n=62] than those with simple lesions 0.28（0.14～0.64） μg/L,n=46]（P〈0.05）.Polytomous Logistic regression analysis demonstrated that serum sLOX-1 level was independently associated with complex lesions（odds ratio 2.99,95%confidence interval 1.47 to 6.08,P=0.003）.Pearman correlation analysis showed a positive correlation between log（sLOX-1） and log（Gensini Score）（correlation coefficient=0.458,P〈0.05）.1.10 μg/L is the critical value of serum sLOX-1 in the diagnosis of stable angina with sensitivity of 54.8% and specificity of 93.5%（P〈0.05）. Conclusion Serum sLOX-1 level is related to coronary lesion complexity in patients with stable angina pectoris which may be an independent risk factor for prediction of coronary plaque vulnerability and rupture.

关 键 词：稳定型心绞痛 凝集素样氧化型低密度脂蛋白受体1 冠状动脉复杂病变 不稳定性斑块 

分 类 号：R5[医药卫生—内科学]