血浆脂蛋白相关磷脂酶A2与急性心肌梗死患者心功能的相关性研究  

Relationship between concentration of plasma Lp-PLA2 and cardiac function after acute myocardial infarction

作　　者：吴鑫 钱焱霞 庞斯斯 徐冰[4] 王俊宏[2] Wu Xin;Qian Yanxia;Pang Sisi;Xu Bing;Wang Junhong(Laboratory of Obstetrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Geriatric Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Cardiology,Northern Jiangsu Province Hospital,Yangzhou 210029,China)

机构地区：[1]南京医科大学第一附属医院产科实验室,江苏南京210029 [2]南京医科大学第一附属医院心脏科,江苏南京210029 [3]南京医科大学第一附属医院老年心脏科,江苏南京210029 [4]苏北人民医院心脏科,江苏扬州225001

出　　处：《南京医科大学学报（自然科学版）》2019年第10期1437-1441,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金面上项目（81570328）;江苏省医学重点人才项目（ZDRCB2016005）

摘　　要：目的:研究急性心肌梗死患者血浆脂蛋白相关磷脂酶A2(Lp-PLA2)浓度变化情况及其与心肌梗死后心功能的相关性。方法:连续入选急性心肌梗死患者90例,测定患者入院即刻(T0)、入院次日(T1)、入院第3天(T2)和入院第7天(T3)血浆Lp-PLA2及心梗后1个月(T4)N端前体脑钠肽(NT-proBNP)水平,并采用二维心脏超声测定T1和T4患者左室射血分数(LVEF),Pearson相关分析Lp-PLA2与LVEF及NT-proBNP的相关性。以43例同期入院稳定性心绞痛患者和48例健康体检者作为对照。结果:急性心肌梗死患者血浆Lp-PLA2水平呈动态改变,心梗发作时显著增高,而入院第7天后基本降至对照组水平[(61.42±36.99)mg/L vs.(49.83±27.17)mg/L,P> 0.05]。相关性分析显示入院即刻(T0)血浆Lp-PLA2水平与C反应蛋白水平(r=0.06,P> 0.05)及血浆肌钙蛋白T水平(r=-0.07,P> 0.05)均无显著相关性。进一步研究发现入院时(T0)血浆Lp-PLA2水平与T4血浆NT-proBNP水平(P=0.16,P> 0.05)、左室射血分数(LVEF)(r=-0.09,P> 0.05)及T4与T1 LVEF差值(ΔLVEF)(r=0.04,P> 0.05)均无显著相关性。结论:血浆Lp-PLA2水平反映了急性心肌梗死动脉斑块不稳定状态,但与急性心肌梗死患者梗死后心功能恢复情况无关。Objective:To study the change of plasma lipoprotein-associated phospholipase A2(Lp-PLA2)concentration in patients with acute myocardial infarction(AMI)and its correlation with cardiac function after AMI. Methods:Ninety consecutive AMI patients who met the study criteria were enrolled. The plasma Lp-PLA2 levels were measured immediately after admission(T0),the next day(T1),the third day(T2),and the seventh day(T3),N-terminal pro brain natriuretic peptide(NT-proBNP)was measured one month after AMI(T4),left ventricular ejection fraction(LVEF)was measured by two-dimensional echocardiography at T1 and T4. Pearson correlation analysis was used to analyze the correlation between Lp-PLA2 and LVEF or NT-proBNP. In addition,48 healthy volunteers and 43 stable angina pectoris patients were enrolled as the controls. Results:The level of plasma Lp-PLA2 showed dynamic changes after AMI,it was increased significantly after the onset of the disease,but decreased to normal level after 7 th days of admission[(61.42±36.99)mg/L vs.(49.83±27.17)mg/L,P > 0.05]. The correlation analysis showed that there was no significant correlation between on-admission plasma Lp-PLA2 and C-reactive protein level(r=0.06,P > 0.05)or between Lp-PLA2 and cardiac troponin T level(r=-0.07,P > 0.05). Further studies showed that there was no significant correlation between plasma Lp-PLA2 level at T0 and plasma NT-proBNP level at T4(r=0.16,P > 0.05)or LVEF at T4(r=-0.09,P > 0.05)or the difference of LVEF between T1 and T4(r=0.04,P > 0.05). Conclusion:The plasma level of Lp-PLA2 showed dynamic changes after AMI,which reflected the unstable state of artery plaques,but it was not related to the recovery of cardiac function after AMI.

关 键 词：急性心肌梗死 脂蛋白相关磷脂酶A2 左室射血分数 

分 类 号：R542.2[医药卫生—心血管疾病]