冠心病患者血浆脂蛋白相关磷脂酶 A2与冠状动脉病变的相关性研究  

The relationship between plasma lipoprotein-associated phospholipase A2 and coronary atherosclerosis in patients with coronary heart disease

作　　者：张冬芹[1] 曾玉杰[2] 董道然[3] 朱丹[3] 李楠[3] 

机构地区：[1]河北省保定市第一中心医院老年病一科,071028 [2]首都医科大学附属北京安贞医院急诊危重症中心 [3]中日友好医院心内科

出　　处：《中国医药》2014年第9期1253-1257,共5页China Medicine

基　　金：首都医学发展科研基金（2009-3022）

摘　　要：目的探讨冠状动脉粥样硬化性心脏病（冠心病）患者血浆脂蛋白相关磷脂酶 A2（Lp-PLA2）水平与冠状动脉粥样斑块稳定性和冠状动脉病变程度的关系。方法选取2011年5-12月在中日友好医院接受冠状动脉造影（ CAG）的患者254例，根据CAG结果分为冠心病组（ n＝206）和排除冠心病的对照组（n＝48）。冠心病组按临床类型分为稳定型心绞痛（SAP）、不稳定型心绞痛（UAP）和急性心肌梗死（ AMI）3个亚组；按冠状动脉病变支数可分为单支病变、双支病变和三支病变3个亚组；按冠状动脉Gensini积分可分为0～19分、20～39分和≥40分3个亚组。所有患者应用酶联免疫吸附法测定血浆Lp-PLA2水平，同时收集患者年龄、性别、体重指数、高血压病史、糖尿病病史、吸烟史等临床资料及总胆固醇、三酰甘油、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、高敏C反应蛋白（hs-CRP）等实验室数据。结果①冠心病组血浆Lp-PLA2水平明显高于对照组[（180±37）μg/L比（160±44）μg/L， P＜0．01]。②SAP、UAP、AMI亚组的血浆Lp-PLA2水平均高于对照组，差异均有统计学意义[（183±38）、（178±34）、（181±38）μg/L比（160±44）μg/L，均P＜0．05]，但SAP、UAP、AMI亚组之间的差异无统计学意义（P＞0．05）。③冠心病组中，随着病变支数和Gensini积分的增加，血浆Lp-PLA2水平呈逐渐升高趋势，各亚组Lp-PLA2水平均高于对照组，差异有统计学意义[病变支数冠状动脉单支、双支、三支病变各亚组（177±41）、（182±32）、（183±35）μg/L和Gensini积分0～19分、20～39分、≥40分各亚组（175±38）、（179±38）、（182±36）μg/L比（160±44）μg/L，均P＜0．05]，但各亚组间差异无统计学意义（P＞0．05）。④血浆Lp-PLA2水平与年龄、体重指数、总胆固醇、三酰甘油、LDL-C、HDL-C、hs-CRP、高血压病史、糖�Objective To discover the relationship between the plasma lipoprotein-associated phospho-lipase A2 （Lp-PLA2） level, the stability of coronary atherosclerotic plaque and degree of coronary atherosclerosis in patients with coronary heart disease （CHD）.Methods Two hundred and fifty-four patients who received the coronary angiography （ CAG） in China-Japan Friendship Hospital were selected .According to the CAG results , they were divided into CHD group （n=206） and control group excluded of CHD （n=48）.According to the clini -cal types, the CHD group was further divided into subgroups of stable angina pectoris （ SAP）, unstable angina pectoris （ UAP） and acute myocardial infarction （ AMI） .According to the number of diseased coronary branches , it was divided into subgroups of lesion in single , double or triple vessels .According to Gensini′score, the group was divided into three subgroups of 0 to 19 scores, 20 to 39 scores and ≥40 scores.Plasma levels of Lp-PLA2 were detected by enzyme-linked immunosorbent assay （ ELISA） .Clinical information and biochemical data such as age, sex, body mass index （BMI）, prior medical history including hypertension , diabetes mellitus and smoking status, levels of total cholesterol（TC）, triglyceride, low density lipoprotein-cholesterol（LDL-C）, high density lip-oprotein-cholesterol （ HDL-C ） and high-sensitivity C-reactive protein （ hs-CRP ） were obtained before CAG . Results ①The level of Lp-PLA2 was significantly higher in CHD group than that in the control group [（180 ± 37）μg/L vs （160 ±44）μg/L, P〈0.01].②Compared with the control group , levels of Lp-PLA2 were higher in SAP group, UAP group and AMI group[（183 ±38）,（178 ±34）,（181 ±38）μg/L vs （160 ±44）μg/L, all P〈0.05].There were no significant differences in the levels of Lp-PLA2 between SAP, UAP and AMI group （P〉0.05）.③In CHD group, the level of Lp-PLA2 increased with the increasing number of diseased coronary bran-ches and G

关 键 词：冠状动脉粥样硬化性心脏病 人脂蛋白相关磷脂酶A2 动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]