血清脂蛋白相关磷脂酶A2与急性冠脉综合征的相关性研究  

Correlation between lipoprotein associated phospholipase A2 and acute coronary syndrome

作　　者：柴芳芳[1] 李新华[1] 方伟[1] 武丽娜[1] 颜文华[1] 

机构地区：[1]郑州大学第五附属医院心内科,郑州450052

出　　处：《医药论坛杂志》2017年第3期31-34,共4页Journal of Medical Forum

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(lipoprotein associated phospholipase A2,Lp-PLA2)水平与急性冠脉综合征(acute coronary syndrome,ACS)及其危险程度的相关性。方法 156例入选患者根据临床及造影结果分为对照组30例、稳定型心绞痛组31例、急性冠状动脉综合征组95例。又根据全球急性冠状动脉事件注册(Global Registry of Acute Coronary events,GRACE)危险评分将ACS组分为低危组(1-108分,39例)、中危组(109-140分,30例)、高危组(>140分,26例)。检测血清Lp-PLA2、hs-CRP水平,用Spearman相关分析法分析血清脂蛋白相关磷脂酶A2与急性冠脉综合征患者冠状动脉病变支数、GRACE危险评分、hs-CRP的相关性。结果 ACS组和SAP组Lp-PLA2均高于对照组(P<0.05),且ACS组高于SAP组(P<0.05)。spearman相关性分析显示ACS患者血清Lp-PLA2水平与冠脉病变支数、GRACE危险评分呈显著正相关关系(r=0.454,P<0.01;r=0.499,P<0.01),Lp-PLA2与hs-CRP无相关性(r=0.154,P>0.05)。随着GRACE危险程度的升高,血清Lp-PLA2、hs-CRP出现显著升高,差异有统计学意义(P<0.05)。结论血清Lp-PLA2水平与冠心病临床严重程度密切相关,可用于间接评估粥样斑块的稳定性及冠脉病变范围,对ACS早期危险分层、预后评估及诊疗方案的选择有重要临床参考价值。Objective To explore the correlation bteween the Lp - PLA2 and the ACS, risk severity of ACS. Methods Totally 156 enrolled cases were divided into three groups according to the clinical condition and results of eardioangiogra- phy： control group（ 30 eases）, stable angina peetoris group （31 cases）, acute coronary syndrome group（95 cases）. ACS group was divided into low risk group（ 1 - 108 score, 39 cases） , intermediate risk group （ 109 - 140 score, 30 ca- ses）, high risk group （ 〉 140 score, 26 cases） according to GRACE risk score. We tested the serum levels of Lp - PLA2 and hs - CRP. The correlation of Lp - PLA2 with the numbers of angiographie coronary artery lesions, GRACE risk score, hs - CRP in ACS group was analyzed by the Spearman relevance analysis. Results The serum Lp - PLA2 of ACS and SAP group were higher than that of control group, and the serum Lp - PLA2 of ACS group was higher than that of SAP group. The Spearman relevance analysis showed that serum Lp - PLA2 had a positive correlation with the num- bers of angiographic coronary artery lesions, GRACE risk score （r = 0. 454, P 〈 0. 01 ;r = 0. 499, P 〈 0. 01 ）, Lp - PLA2 and hs - CRP had no obvious correlation（r =0. 154,P 〉0. 05）in ACS group. With the increase of GRACE risk level, the serum level of Lp - PLA2 was significantly increased, and the difference was statistically significant （ P 〈 0. 05 ）. Conclusion The level of serum Lp - PLA2 is closely associated with clinical severity of coronary heart disease ; which could be used to assess the stablity of atheromatous plaque indirectly and coronary artery lesions range. For the ACS pa- tients, it has the important clinical value on early risk stratification, evaluation of prognosis and treatment options.

关 键 词：急性冠脉综合征 脂蛋白相关磷脂酶A2 GRACE危险评分 冠脉病变支数 

分 类 号：R541.4[医药卫生—心血管疾病]