冠心病患者血清脂蛋白相关磷脂酶A2水平与冠状动脉斑块稳定性的关系  

Association between the change of serum lipoprotein associated phospholipase A2 level and the stability of coronary artery plaque in patients with coronary artery disease

作　　者：邱谷[1] 刘培龙[1] 朱俊泉 戴世荣[1] 张曙晴 

机构地区：[1]江苏省南通市第二人民医院检验科,226002 [2]江苏省南通市第二人民医院心内科,226002

出　　处：《检验医学与临床》2016年第21期3029-3031,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平与冠心病(CAD)及其斑块稳定性关系。方法选择在本院就诊的冠心病患者126例为冠心病组,其中包括稳定性冠心病(SCAD)31例、不稳定型心绞痛(UAP)68例和急性心肌梗死(AMI)27例,以同期本院健康体检者119例作为健康对照组。检测所有入选研究对象血清Lp-PLA2、缺血修饰白蛋白(IMA)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)和血脂指标,对检测结果进行统计分析。结果冠心病组和健康对照组血清Lp-PLA2水平分别为(265.2±23.4)、(166.3±15.3)ng/mL,冠心病组显著高于健康对照组,差异有统计学意义(P<0.01);冠心病患者血清LpPLA2与低密度脂蛋白胆固醇(LDL)正相关(r=0.522,P<0.01),与载脂蛋白B(apoB)正相关(r=0.516,P<0.001),相关程度较高,与IMA正相关(r=0.227,P=0.039),而与hs-CRP无相关性(r=0.077,P=0.245),与PCT无相关性(r=0.012,P=0.871);SCAD组、UAP组和AMI三组血清Lp-PLA2水平分别为(192.3±18.3)、(266.9±22.4)、(284.1±34.2)ng/mL,血清LpPLA2水平随着冠状动脉粥样斑块不稳定程度的增加明显升高(P<0.01)。结论冠心病患者血清Lp-PLA2水平显著升高。Lp-PLA2主要与脂质代谢,特别是LDL代谢相关。对于冠心病患者,Lp-PLA2作为一种新的炎性形成标志物,与粥样斑块稳定性直接相关,是一个良好的临床评估指标。Objective To observe the association between the serum lipoprotein associated phospholipase A2（Lp-PLA2）level and the stability of coronary artery plaque in patients with coronary artery disease（CAD）.Methods Totally 126 CAD patients with CAD were selected,including 31 patients with stable CAD（SCAD）,68 patients with unstable angina pectoris（UAP）and 27 patients with acute myocardial infarction（AMI）.And 119 healthy people were selected as control group.The concentrations of serum Lp-PLA2,ischemia modified albumin（IMA）,high sensitive C reactive protein（hs-CRP）,procalcitonin（PCT）and lipids were determined in all the subjects.The test results were compared and analyzed.Results The level of serum Lp-PLA2 in patients with CAD and control group were（265.2±23.4）ng/mL and（166.3±15.3）ng/mL respectively.The level of Lp-PLA2 in patients with CAD was significantly higher than that of healthy controls（P〈0.01）.Lp-PLA2 was positively correlated with low density lipoprotein cholesterol（LDL）（r=0.522,P〈0.01）,apolipoprotein B（apoB）（r=0.516,P〈0.01）and was correlated with IMA（r=0.227,P=0.039）.While it was not correlated with hs-CRP（r=0.077,P=0.245）and PCT（r=0.012,P=0.871）.The level of serum Lp-PLA2 in the patients with SCAD group,UAP group and AMI group were（192.3±18.3）,（266.9±22.4）and（284.1±34.2）ng/mL.The level of Lp-PLA2 increased with the degree of coronary artery plaque instability（P〈0.01）.Conclusion LpPLA2 level in patients with coronary artery disease is significantly higher than that of healthy controls.Lp-PLA2 is correlated with important inlipid metabolism,especially with metabolism of LDL.As a new kind of inflammation markers,Lp-PLA2 is closely associated with stability of coronary artery plaque.So it is a good evaluate indicator for evaluation of coronary artery disease.

关 键 词：脂蛋白相关磷脂酶A2 冠心病 冠状动脉斑块 

分 类 号：R541.4[医药卫生—心血管疾病]