慢性肾衰患者血浆脂蛋白相关磷脂酶A_2与动脉粥样硬化的关系  

The Role of Lipoprotein-associated Phospholipase A_2 on Atherosclerosis in Patients with Chronic Renal Failure

作　　者：张祖隆[1] 王蕴倩[1] 

机构地区：[1]贵阳医学院附属医院肾内科,贵州省贵阳市550004

出　　处：《中国动脉硬化杂志》2011年第2期143-146,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的研究慢性肾功能衰竭患者血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平与动脉粥样硬化的关系。方法选择慢性肾功能衰竭患者100例和健康对照40例采用酶联免疫吸附(ELISA)法测定血浆脂蛋白相关磷脂酶A2水平,超声技术检测颈动脉内膜中膜厚度和粥样硬化斑块。比较慢性肾衰患者与对照组血浆Lp-PLA2水平及慢性肾功能衰竭患者不同分组间Lp-PLA2水平,并对影响颈动脉颈动脉内膜中膜厚度的多因素进行逐步回归分析。结果慢性肾功能衰竭患者血浆Lp-PLA2水平明显高于健康对照组(232.16±59.36μg/L比129.47±29.72μg/L,P<0.01);透析者血浆Lp-PLA2水平明显高于未透析者(261.84±50.82μg/L比204.73±53.95μg/L,P<0.01);未透析者血浆Lp-PLA2水平与内生肌酐清除率呈负相关(r=-0.567,P<0.01)。有颈动脉粥样斑块者血浆Lp-PLA2水平明显高于无动脉粥样斑块者(281.33±39.72μg/L比188.46±35.02μg/L,P<0.01)。多因素逐步回归分析均显示血浆Lp-PLA2水平与颈动脉内膜中膜厚度呈正相关(β=0.735,P<0.01)。结论慢性肾功能衰竭患者动脉硬化病变与血浆Lp-PLA2水平有关,血浆Lp-PLA2水平升高可能参与了慢性肾功能衰竭患者动脉粥样硬化的发生和发展。Aim To investigate whether atherosclerosis may be accelerated by lipoprotein-associated phospholipase A2（Lp-PLA2） in patients with chronic renal failure（CRF）. Methods 100 patients of CRF and 40 healthy volunteers were involved in the study.The levels of plasma Lp-PLA2 were determined by enzyme-linked immunosorbent assay（ELISA）.Intima-middle thickness（IMT） and prevalence atherosclerotic plaques of the extrcranial common carotid artery were measured by high-resolution B-mode ultrasonography. The CRF group level of plasma Lp-PLA2 was compared with the control group.The levels of plasma Lp-PLA2 were compared between the different groups in patients with CRF.The multiple stepwise regression analysis was used for the multi-factor of affecting the carotid artery IMT. Results Higher plasma Lp-PLA2 levels were found in patients with CRF（232.16±59.36 μg/L） as compared with those in healthy controls（129.47±29.72 μg/L,P0.01）. Lp-PLA2 levels in dialysis patients（261.84±50.82 μg/L） were significantly higher than in pre-dialysis patients（204.73±53.95 μg/L,P0.01）. Lp-PLA2 levels increased with the progression of renal dysfunction and inversely correlated with creatinine clearance（Ccr）（r=-0.567,P0.01）.Patients with carotid artery atherosclerotic plaques showed significantly higher levels of Lp-PLA2（281.33±39.72 μg/L） as compared with patients without carotid artery atherosclerotic plaques（188.46±35.02 μg/L,P0.01）. By multiple stepwise regression analysis strong association was still present between Lp-PLA2 levels and carotid artery IMT（β=0.735,P0.01） in the CRF patients. Conclusion The results indicate that atherosclerosis is associated with increase of plasma LpPLA2 in CRF patients.The elevated levels of Lp-PLA2 may be involved in the occurrence and development of atherosclerosis for CRF patients.

关 键 词：慢性肾功能衰竭 脂蛋白相关磷脂酶A2 动脉粥样硬化 颈动脉内膜中膜厚度 

分 类 号：R5[医药卫生—内科学]