急性冠状动脉综合征患者脂蛋白相关磷酯酶A2血浆水平及其临床意义  

Clinical Value of Plasma Level of Lp-LPA2 in Patients with Acute Coronary Syndrome

作　　者：唐其东[1] 吴平生[2] 李瑜辉[1] 侯玉清[2] 谢佳佳[1] 余天浩[1] 陈武奇[1] 

机构地区：[1]广东省第二人民医院心内科,广东省广州市510317 [2]南方医科大学南方医院心内科,广东省广州市510515

出　　处：《中国动脉硬化杂志》2012年第9期829-832,共4页Chinese Journal of Arteriosclerosis

基　　金：广东省医学科学技术研究基金(WSTJJ2009)资助

摘　　要：目的研究脂蛋白相关磷酯酶A2在冠心病患者中的血浆水平,为临床早期诊治急性冠状动脉综合征提供客观指标。方法 230例行冠状动脉造影的心内科住院患者,根据临床表现及冠状动脉造影结果分组:急性冠状动脉综合征组98例,其中包括不稳定型心绞痛组61例,急性心肌梗死组37例;非急性冠状动脉综合征组81例,其中包括稳定型心绞痛组49例、冠状动脉慢性完全闭塞组32例;正常冠状动脉为对照组51例。采用夹心酶联免疫吸附法检测血浆脂蛋白相关磷酯酶A2水平。结果冠心病组脂蛋白相关磷酯酶A2和高敏C反应蛋白水平显著高于对照组(P<0.001);急性冠状动脉综合征组脂蛋白相关磷酯酶A2和高敏C反应蛋白水平显著高于非急性冠状动脉综合征组(P<0.05或P<0.001)。与对照组比较,稳定型心绞痛组血浆脂蛋白相关磷酯酶A2水平无显著性增高(P>0.05),不稳定型心绞痛组、急性心肌梗死组、冠状动脉慢性完全闭塞组血浆脂蛋白相关磷酯酶A2水平有极显著性增高(P<0.001),而高敏C反应蛋白水平在所有亚组显著增高(P<0.001)。结论急性冠状动脉综合征患者血浆脂蛋白相关磷酯酶A2水平明显增高,其水平升高提示冠状动脉粥样硬化斑块的不稳定性,有可能作为急性冠状动脉综合征的有效预测指标。Aim To evaluate the levels of plasma lipoprotein associated phospholipase A2 （Lp-LPA2） in pa- tients with coronary heart disease （CHD） and provide effective biomarkers for early diagnosis of acute coronary syndrome （ACS）. Methods 230 subjects with angiographic inpatients were didvided into three groups： ACS group with 98 ca- ses, Non-ACS group with 81 cases, and normal cornary artery group （NCA） as control with 51 cases. ACS group includ- ed unstable angina pectoris （UAP） subgroup with 61 patients and acute myocardial infarction （AMI） subgroup with 37 pa- tients; Non-ACS group included stable angina pectoris （SAP） subgroup with 49 cases and chronic total occlusion （CTO） subgroup with 32 patients. Plasma concentrations of Lp-LPA2 in all individuals were measured using commercial kit by enzyme linked immunosorbent assay （ELISA）. Results Lp-LPA2 and hs-CRP levels were significantly higher in CHD patients including ACS and Non-ACS groups than in NCA group （P 〈 0. 001 ）. ACS group showed very significantly higher Lp-LPA2 levels （ P 〈 0. 001 ） and higher hs-CRP level（P 〈 0.05 ） than Non-ACS group. Compared with NCA group, subgroups including UAP, AMI, and CTO subgroup showed obvious increases in plasma Lp-LPA2 levels （P 〈 0. 001 ）, and SAP subgroup showed no significant increase （P 〉 0.05 ）. Hs-CRP level was significantly higher in every subgroup （P 〈 0. 001 ）. Conclusions Elevated Lp-LPA2 levels in CHD patients suggest the instability of atheroscle- rotic plaque and may be viewed as aneffective indicator for prediction of ACS.

关 键 词：急性冠状动脉综合征 不稳定型心绞痛 急性心肌梗死 冠状动脉慢性完全闭塞 脂蛋白相关 磷酯酶A2 

分 类 号：R5[医药卫生—内科学]