脂蛋白相关性磷脂酶A2和巨噬细胞迁移抑制因子与易损斑块相关性的iMap-血管内超声研究  

An iMap-IVUS study for the correlation of Lp-PLA2 and MIF and vulnerabl plaques

作　　者：赵茹[1] 张静[1] 丛洪良[1] 

机构地区：[1]天津市胸科医院,天津300000

出　　处：《临床心血管病杂志》2015年第5期560-563,共4页Journal of Clinical Cardiology

基　　金：天津市卫生局课题(No:2010KZ63);天津市卫生计生委科技基金(No:14KG126)

摘　　要：目的:通过iMap-血管内超声(iMap-IVUS)分析冠心病患者动脉粥样硬化斑块成分,探讨脂蛋白相关性磷脂酶A2(Lp-PLA2)及巨噬细胞迁移抑制因子(MIF)水平与易损斑块间的关系。方法:连续选取冠心病患者74例,对其3支冠状动脉(冠脉)均进行IVUS检查,通过IVUS后处理软件测量患者冠脉管腔面积、斑块成分等相关指标,并根据患者病变性质将其分为斑块破裂组、易损斑块组和无易损斑块组,分析Lp-PLA2及MIF水平与患者易损斑块间的关系。结果:斑块破裂组较非斑块破裂组病变长度更长(P<0.001),有更大的外弹力膜面积(P=0.014)和斑块面积(P=0.008),含有更多的脂质成分(P=0.009)和坏死核心(P<0.001)。易损斑块组较无易损斑块组患者有更多的脂质成分(P<0.05)和坏死核心(P<0.001)。斑块破裂组Lp-PLA2水平明显高于非斑块破裂组(P=0.001),MIF水平差异无统计学意义;与无易损斑块组相比,易损斑块组Lp-PLA2水平显著升高(P=0.001),MIF水平未见统计学差异。Lp-PLA2与斑块易损性呈中等相关(r=0.448,P<0.01),MIF与斑块易损性无明显相关性(r=0.121,P>0.05)。结论:经iMAP-IVUS证实,Lp-PLA2能够反映斑块的易损性,MIF不能作为易损斑块的预测因子。Objective.. To investigate relationships among lipoprotein associated phospholipase A2 （Lp-PLA2） and macrophage migration inhibitory factor （MIF） and vulnerable plaques by analysis of atheroselerotie plaque components using iMap-intravascular ultrasound（IVUS）. Method： Seventy-four patients with coronary heart dis- ease were included. Patients＇s three vessels were performed on iMap-IVUS. The relationships among Lp-PLA2, MIF levels and vulnerable plaques measured using IVUS post-processing software. Result：Ruptured plaque group had longer lesion length （P〈0.001 ） , greater external elastic membrane area （P = 0.014） and plaque area （ P = 0. 008）, containing more lipid composition （P=0. 009） and necrotic core （P〈0. 001） than the group without rup- tured plaque. The vulnerable plaque group had more lipid composition （P〈0.05） and necrotic core （P〈0. 001） than the group without vulnerable plaque group. Ruptured plaque group＇s Lp-PLA2 level was significantly higher than that in the group without plaque ruptured （P=0. 001）, while levels of MIF had no statistical difference （P〈 0.05）; Compared with the group without vulnerable plaque, the level of Lp-PLA2 increased significantly （P= 0. 001） in the vulnerable plaque group. The level of MIF had no statistical difference between two groups. Lp- PLA2 level was moderately correlated to the vulnerable plaque （r= 0. 448, P〈0.01）, while MIF level had no significant correlation with the vulnerable plaque （r=0. 121, P〉0.05）. Conclusion： Confirmed by the iMAP-IVUS, Lp-PLA2 could reflect the vulnerability of the plaques, but MIF can not as a predictor of vulnerable plaques.

关 键 词：脂蛋白相关性磷脂酶A2 巨噬细胞迁移抑制因子 易损斑块 iMap-血管内超声 

分 类 号：R541.4[医药卫生—心血管疾病]