脂蛋白相关性磷脂酶A2与冠状动脉病变程度及心功能变化的关系  

Relationship of Lipoprotein-associated Phospholipase A2 With the Severity of Coronary Artery Lesion and the Changes of Cardiac Function

作　　者：郑永红[1] 鹿秀霞[2] 陈德伟[1] 

机构地区：[1]福建省立医院,福建省福州市350001 [2]宁德市医院超声科

出　　处：《中国全科医学》2015年第20期2398-2401,共4页Chinese General Practice

摘　　要：目的探讨冠心病患者血浆脂蛋白相关性磷脂酶A2(Lp-PLA2)水平与冠状动脉病变严重程度及心功能的关系。方法选取2012年1—12月在福建省立医院心内科住院并行冠状动脉造影(CAG)检查的患者122例,根据CAG、典型的临床表现、心电图、心肌酶学指标将患者分为对照组30例、稳定型心绞痛(SAP)组30例、不稳定型心绞痛(UAP)组32例、急性心肌梗死(AMI)组30例。抽取患者外周静脉血,采用速率法检测空腹血糖(FBG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C),采用免疫比浊法检测高敏C反应蛋白(hs-CRP),采用免疫法检测N末端B型脑钠肽前体(NT-pro BNP),采用酶联免疫吸附试验(ELISA)测定Lp-PLA2。应用Gensini评分系统,对患者冠状动脉狭窄程度进行评分。采用超声心电图检测左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)等心脏收缩功能指标。结果各组性别、年龄、血压、FBG、TC和Gensini积分比较,差异均无统计学意义(P>0.05);各组LDL-C、hs-CRP、lg NT-pro BNP、Lp-PLA2水平比较,差异均有统计学意义(P<0.05);其中UAP组和AMI组LDL-C、hs-CRP水平均高于对照组和SAP组(P<0.05);AMI组hs-CRP水平高于UAP组(P<0.05);SAP组、UAP组和AMI组lg NT-pro BNP、Lp-PLA2水平均高于对照组,AMI组lg NT-pro BNP水平高于SAP组和UAP组(P<0.05),UAP组和AMI组Lp-PLA2水平均高于SAP组,AMI组Lp-PLA2水平高于UAP组(P<0.05)。各组LVEDV、LVESV和LVEF比较,差异均有统计学意义(P<0.05);其中SAP组、UAP组和AMI组LVEDV和LVESV均高于对照组,LVEF均低于对照组;UAP组和AMI组LVEDV和LVESV均高于SAP组,AMI组LVEF低于SAP组;AMI组LVEDV和LVESV均高于UAP组,LVEF低于UAP组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,血浆Lp-PLA2水平与LDL-C(r=0.298,P<0.01)、hs-CRP(r=0.515,P<0.001)、lg NT-pro BNP(r=0.743,P<0.01)、LVEDV(r=0.550,P<0.001)、LVESV(r=0.603,P<0.001)均呈正相关,与LVEF呈负相关(r=-0.707,P<0.001Objective To investigate the relationship of lipoprotein-associated phospholipase A2 with the severity of coronary artery lesion and the changes of cardiac function.Methods From January to December in 2012,we enrolled 122 patients who were admitted into the cardiology department of Fujian Provincial Hospital and received coronary arteriography（CAG） there.According to the results of CAG,typical clinical manifestations,electrocardiogram and the indicators of myocardial enzyme,the subjects were divided into control group（n = 30）,SAP group（n = 30）,UAP group（n = 32） and AMI group（n = 30）.Peripheral venous blood was sampled; FBG,TC,LDL-C were tested by velocity method; hs-CRP was tested by immunoturbidimetry method; NT-pro BNP was tested by immunization method; Lp-PLA2 was tested by ELISA.The degree of coronary artery stenosis was assessed using Gensini score system.Ultrasound cardiogram was employed to examine the indicators of systolic function including LVEDV,LVESV and LVEF.Results The groups were not significantly different（P 0.05） in gender,age,blood pressure,FBG,TC and Gensini integral; the groups were significantly different（P 0.05） in the levels of LDL-C,hs-CRP,lg NT-pro BNP and Lp-PLA2; the UAP group and the AMI group were higher（P 0.05） than the control group and SAP group in the LDL-C,hs-CRP level; the AMI group was higher（P 0.05） than the UAP group in the level of hs-CRP; the SAP group,UAP group and AMI group were higher（P 0.05） than the control group in the level of lg NT-pro BNP,Lp-PLA2; the AMI group was higher（P 0.05） than the SAP group and UAP group in the level of lg NT-pro BNP; the UAP group and AMI group were higher（P 0.05） than the SAP group in the level of Lp-PLA2; the AMI group was higher（P 0.05） than the UAP group in the level of Lp-PLA2.The groups were significantly different（P 0.05） in LVEDV,LVESV and LVEF; the SAP group,UAP group and the AMI group were higher（P 0.05）in LVEDV and LVESV and lower（P 0.05） in LVEF than the control gr

关 键 词：冠心病 脂蛋白相关性磷脂酶A2 冠状动脉狭窄 心室功能 左 

分 类 号：R541.4[医药卫生—心血管疾病]