PCI引起冠心病患者血清ox-Lp(a)和β_2-GPI-ox-Lp(a)水平升高  

Changes of Serum ox-Lp(a) and β_2-GPI-ox-Lp(a) in Patients with Coronary Intervention

作　　者：杨琛[1] 时永辉[1] 訾瑞峰[1] 牛冬梅[1] 汪俊军[1] 张春妮[1] 

机构地区：[1]南京大学医学院附属金陵医院检验科,江苏南京210002

出　　处：《标记免疫分析与临床》2014年第3期221-224,231,共5页Labeled Immunoassays and Clinical Medicine

基　　金：国家自然科学基金项目(NSFC 30950100)

摘　　要：目的检测比较冠心病(coronary heart disease,CHD)患者经皮冠状动脉介入治疗术(percutaneous coronary intervention,PCI)前、后血清氧化脂蛋白(a)[ox-Lp(a)]和!β2-糖蛋白I-氧化脂蛋白(a)[β2-GPI-ox-Lp(a)]复合物水平,探讨这两种指标能否反映PCI术后的炎症和氧化应激状态。方法分别于PCI术前及术后3天收集60例CHD患者血清标本,同时收集35例非CHD者冠状动脉造影前后的血样。血清ox-Lp(a)和β2-GPI-ox-Lp(a)水平测定均采用双抗体夹心酶联免疫吸附法(ELISA方法)。同时测定血样的常规血脂指标以及炎症指标超敏C-反应蛋白(high-sensitivity Creactive protein,hs-CRP)。结果 CHD患者PCI术后hs-CRP水平显著高于PCI术前(9.31±8.22 mg/L vs 4.96±5.57mg/L,P<0.05);血清ox-Lp(a)(10.51±9.39 mg/L vs 7.38±6.65 mg/L,P<0.05)和β2-GPI-ox-Lp(a)(1.70±2.37U/mL vs 0.91±1.07 U/mL,P<0.05)水平在PCI术后也显著升高;而其他常规血脂水平PCI术后无明显变化。相关性分析显示,CHD患者PCI术前ox-Lp(a)和β2-GPI-ox-Lp(a)均与血管狭窄比例和病变支数呈正相关关系(P<0.05);ox-Lp(a)和β2-GPI-ox-Lp(a)两指标之间在PCI术前、后均呈正相关关系(均P=0.0001)。此外,冠状动脉造影也导致β2-GPI-ox-Lp(a)水平升高。结论 PCI手术引起血清ox-Lp(a)和β2-GPI-ox-Lp(a)水平升高,这两种指标若与hs-CRP联合检测将可能有助于监控PCI术所引起的机体氧化应激和炎症状态。Objective To assess whether serum oxidized lipoprotein （a） [ox-Lp （a）] and the complex of β2-glycoprotein I with ox-Lp （a） [β2-GPI-Lp （a）] levels are elevated after percutaneous coronary intervention （PCI） and whether can be used as additional inflammatory factors to reflect the oxidative stress state during PCI.Methods Serum samples were collected from 60 patients with coronary heart disease （CHD） before and within three days after PCI.In addition,serum samples were also collected from 35 non-CHD individuals before and after coronary arteriongraphy （CAG）.Serum levels of ox-Lp （a） and β2-GPI-Lp （a） were measured with sandwich ELISAs.Some other traits including serum lipids and high-sensitivity C-reactive protein （hs-CRP）were also were measured.Results The serum hs-CRP levels in CHD patients after PCI were significantly elevated as compared with those before PCI （9.31 ± 8.22 mg/L vs 4.96 ± 5.57mg/L,P 〈 0.05）.The serum concentrations of ox-Lp （a） and β2-GPI-ox-Lp （a） were also markedly increased （10.51 ± 9.39 mg/L vs 7.38 ±6.65 mg/L,P 〈0.05 ; 1.70 ±2.37 U/mL vs 0.91 ± 1.07 U/mL,P 〈 0.05,respectively）.While routine serum lipids levels did not display marked change after PCI.Both the serum ox-Lp（a） and β2-GPI-ox-Lp（a） concentrations in CHD patients were significantly positively correlated with the percentage of diameter of stenosis and number of vessel disease.β2-GPI-ox-Lp（a） was positively correlated with ox-Lp（a） in CHD patients either before or after PCI （P =0.0001）.In addition,CAG also resulted in the elevation of β2-GPI-ox-Lp （a） levels.Conclusion The serum ox-Lp （a） and β2-GPI-ox-Lp （a） concentration were increased in CHD patients after PCI,suggesting that measurement of these two traits together with hs-CRP might be useful as in monitoring the inflammation and oxidative stress state during PCI.

关 键 词：氧化脂蛋白(a) β2-糖蛋白I-氧化脂蛋白(a)复合物 经皮冠状动脉介入治疗术 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]