高敏C反应蛋白、同型半胱氨酸、白细胞介素2和脂蛋白相关磷脂酶A2与冠心病的相关性研究  

Correlation study among high-sensitivity C-reactive protein,homocysteine,interleukin-2,lipoprotein-associated phospholipase A_2 and coronary heart disease

作　　者：郑冠群[1] 盛晓东[1] 周建龙[1] 范韬[1] 金骁琦[1] Zheng Guanqun;Sheng Xiaodong;Zhou Jianlong;Fan Tao;Jin Xiaoqi(Department of Cardiology, the Changshu Hospital Affiliated to Medical College of Yangzhou University,Changshu 215500, China)

机构地区：[1]扬州大学医学院附属常熟医院心血管内科,215500

出　　处：《中国心血管杂志》2016年第3期218-222,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的检测冠心病患者外周血高敏C反应蛋白（hS-CRP)、同型半胱氨酸（Hey)、白细胞介素2(IL-2)和脂蛋白相关磷脂酶A2(Lp-PLA2)水平，探讨其与冠心病的关系及临床应用价值。方法选择2014年1月至2015年3月在扬州大学医学院附属常熟医院心内科就诊的冠心病患者123例作为研究组，依据冠心病不同类型分为稳定型心绞痛（SAP)42例、不稳定型心绞痛（UAP)40例和急性心肌梗死（AMI)41例3个组，另选取40例同期行冠状动脉造影术（CAG)未见冠状动脉狭窄者作为对照组。在常规冠心病药物治疗前抽取外周血测定血浆hS-CRP、Hcy、IL-2和Lp-PLA2水平及其他生化指标，并进行比较。结果AMI组患者的Hcy、hS-CRP、Lp-PLA2水平及载脂蛋白（ap〇)-8/&1)〇-八1比值明显高于对照组、3八？组和1^?组[出^:(19.47±7.86)|^〇1/1^比（8.11±4.02)|junol/L、（10.25±4.56)pmol/L和（13.52±6.13)|junol/L;hs-CRP:(7.78±2.51)mg/L比（1.17±0.74)mg/L、（3.54±1.93)mg/L和（4.62±2.01)mg/L;Lp-PLA2:(298.60±58.12)ng/ml比(124.10±34.52)ng/ml、（207.00±42.37)ng/ml和（244.50±53.22)ng/ml;apo-B/apo-Al:0.80土0.21比0.54±0.19、0.60±0.21和0.62±0.23,均为P<0.05];UAP组IL-2和Lp-PLA2水平显著高于对照组和3八？组[11^-2:(160.34±20.14)?§/1111比（123.75±6.99)?#1111和（147.03±15.96)?§/ml;Lp-PLA2:(244.50±53.22)ng/ml比（124.10±34.52)ng/ml和（207.00±42.37)ng/ml，均为P<0.05];UAP组和AMI组中有吸烟史的患者比例较对照组高，差异均有统计学意义（均为P<0.05)。在冠心病患者中血浆Lp-PLA2水平与Hcy、hs-CRP呈正相关〇=0.376、0.289，均为P<0.05)。多元逐步回归分析显示，Hcy、hS-CRP为影响血浆Lp-PLA2水平的相关因素（《=3.265，P=0.001;?=3.109，P=0.002)。回归分析显示，Lp-PLA2为冠心病独立相关因素=7.926，P=0.005,Ofl(95%C/):1.194(1.069~1.328)]。结论血浆Lp-PLA2水平在冠心病患者中明显升高，是冠心病的独立危险因素，检测LP-PLA2对冠心病Objective By detecting the levels of high-sensitivity C-reactive protein ( h s - C R P ) ,Homocysteine (Hey) , Interleukin (IL)-2 and plasma lipoprotein associated phospholipase A 2( L p - P L A 2) in coronary heart disease ( C H D ) patients to explore their relationship with C H D and prognostic values.Methods The 123 C H D patients from January 2014 to March 2015 in Department of Cardiovascular Medicine in Changshu Hospital Affiliated to Medical College of Yangzhou University were enrolled for the study group. According to the clinical types, the CHD group was further divided into 3 subgroups of stable angina pectoris ( SAP, 42 cases) , unstable angina pectoris ( UAP, 40 cases) and acute myocardialinfarction (AMI, 41 cases). Meanwhile, 40 cases of patients without coronary artery stenosis detected by CAG were selected as control group. The levels of hs-CRP, Hey, IL-2, plasma Lp-PLA2 and some other biochemical indicators in all groups were detected for study before routine medication. Results The levels of Hey, hs-CRP, Lp-PLA2 and the ratio of apolipoprotein ( apo)-B/apo-Al in AMI group were significantly higher than control group, SAP group and UAP group [ Hey:( 19. 47 ± 7. 86) |jLmol/L 仍. (8 .1 1 ± 4 .0 2 ) (jimol/L, ( 10. 25 ± 4. 56 ) (jimol/L and ( 13. 52 ± 6. 13 ) (jimol/L; hs-GRP: ( 7. 78 ± 2. 51 ) mg/L n(1. 17 ±0.74) m g/L,(3.54 ±1.93) mg/L and (4.62 ± 2.01) mg/L; Lp-PLA2: (298.60 ±58. 12) ng/ml ( 124. 10 ± 34. 52 ) ng/ml, (207. 00 ±42. 37) ng/m land (244. 50 ± 53. 22 ) ng/m l; apo-B/apo-A1 : 0. 80 ±0. 21 vs. 0. 54 ±0. 19, 0. 60 ± 0. 21 and 0. 62 ± 0. 23 , all P < 0. 05 ] , and the levels of IL-2and Lp-PLA2 in UAP group were significantly higher than SAP group and control group [ IL-2 : (160. 34 土20.14) pg/mlvs. (123.75 ± 6.99) pg/ml and ( 147. 03 ± 15. 96) pg/m l; Lp-PLA2 : (244. 50 ± 53. 22)n g /m l^. ( 124. 10 ± 34. 52) ng/ml and (207. 00 ±42. 37) ng/ml, a llP < 0 .0 5 ]. Those levels of smokers in UAP group and AMI group were higher than control group (all P < 0. 05 ). The le

关 键 词：冠状动脉疾病 动脉粥样硬化 脂蛋白相关磷脂酶A2 高敏C反应蛋白 同型半胱氨酸 白细胞介素2 

分 类 号：R541.4[医药卫生—心血管疾病]