冠心病患者血浆脂蛋白磷脂酶A2水平与脂蛋白亚组分的相关性研究  

Relationship between plasma Phospholipase A2 Concentrations and Lipoprotein Subfractions in Patients with Stable Coronary Artery Disease

作　　者：吴亚茹 王君 徐瑞霞[1] 张彦[1] 李小林[1] 李莎[1] 郭远林[1] 董倩[1] 刘庚[1] 李建军[1] WU Ya-ru;WANG Jun;XU Rui-xia;ZHANG Yan;LI Xiao-lin;LI Sha;GUO Yuan-lin;DONG Qian;LIU Geng;LI Jian-jun(Division of Dyslipidemia,State Key Laboratory of Cardiovascular Disease,State Key Laboratory of Cardiovascular Disease,Ftiwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室血脂异常与心血管病诊治中心,北京市100037 [2]临沂市郯城县中医医院,山东省276100

出　　处：《中国分子心脏病学杂志》2019年第1期2742-2747,共6页Molecular Cardiology of China

基　　金：北京协和医学院协和青年基金(3332016018;3332018200);首都卫生发展科研专项项目(2016-1-4035)

摘　　要：目的探讨稳定型冠心病(CAD)患者血浆脂蛋白磷脂酶A2 (Lp-PLA2)与脂蛋白亚组分的相关性。方法连续入选未服用降脂药物治疗的受试人群324例(其中CAD患者253例,非CAD 71例),收集临床资料,采用ELISA方法检测血浆Lp-PLA2水平、Lipoprint脂蛋白分类检测仪分析低密度脂蛋白(LDL)和高密度脂蛋白(HDL)亚组分。结果与非CAD相比,CAD患者血浆LpPLA2水平较高(153.61±78.73 vs 131.41±65.49 ng/ml, P=0.028)。单因素变量分析表明,CAD患者血浆Lp-PLA2水平与大颗粒、中等颗粒及小颗粒LDL-C浓度均呈正相关(r=0.213,P=0.001;r=0.353,P<0.001; r=0.187,P=0.003),与LDL颗粒大小呈负相关(r=0.140,P=0.026);血浆Lp-PLA2水平与小颗粒HDL-C浓度呈正相关(r=0.180, P=0.004),而与大颗粒和中等颗粒HDL-C浓度呈负相关(r=0.133, P=0.034; r=0.154, P=0.014),然而在非CAD人群并无相关性。经多因素回归分析调整传统危险因素后,CAD患者血浆Lp-PLA2水平与各大小颗粒的LDL-C浓度以及小颗粒HDL-C浓度仍呈独立正相关(β=0.263,P<0.001;β=0.327, P<0.001;β=0.135, P=0.033;β=0.133, P=0.034)。结论稳定型冠心病患者血浆Lp-PLA2水平不仅与LDL-C浓度及LDL-C各亚组分相关,且与小颗粒HDL-C具有相关性,提示Lp-PLA2与脂蛋白亚组分表型分布可能存在潜在相互作用。Objective To investigate the correlation between plasma phospholipase A2 (Lp-PLA2) and lipoprotein subfractions in patients with stable coronary artery disease (CAD). Methods A total of 324 consecutive subjects who were not treated with lipid-lowering drugs were enrolled (angiographically proven CAD: n = 253;non-CAD: n = 71). Plasma Lp-PLA2 concentrations were measured using ELISA. The low-density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions were determined by Lipoprint System. Results Plasma Lp-PLA2 concentrations were higher in patients with CAD compared with those without CAD (153.61±78.73 vs 131.41±65.49 ng/ml, P= 0.028). The univariable correlation analysis revealed that Lp-PLA2 concentrations were positively correlated with the cholesterol concentrations of each LDL subfractions and the intermediate as well as small HDL subfractions, while negatively linked with the LDL particle size and large HDL-cholesterol (HDL-C) concentrations in CAD group. Furthermore, multivariable regression analysis was performed in patients with CAD and showed that plasma Lp-PLA2 concentrations were independently correlated with the cholesterol concentrations of each LDL subfractions [large LDL-cholesterol (LDL-C):β= 0.263, P <0.001;intermediate LDL-C: β = 0.327, P <0.001;small LDL-C: β = 0.135, P=0.033] and small HDL-C (β= 0.133, P = 0.034), However, no similar results were observed in the non-CAD group. Conclusion Lp-PLA2 concentrations were positively associated with all LDL subfractions and small HDL subfraction, suggesting a potential interaction between Lp-PLA2 and lipoprotein subfraction phenotypes in the status of CAD.

关 键 词：稳定型冠心病 血浆脂蛋白磷脂酶A2 LDL亚组分 HDL亚组分 

分 类 号：R541.4[医药卫生—心血管疾病]