脂蛋白相关磷脂酶A2与早发冠心病的相关性分析  

Correlation analysis of lipoprotein-associated phospholipase A2 and premature coronary heart disease

作　　者：王娜 刘和俊[1] WANG Na;LIU He-jun(Department of Cardiovascular Medicine,First Affiliated Hospital of Anhui Medical University 230022,China)

机构地区：[1]安徽医科大学第一附属医院心血管内科,230022

出　　处：《中国实用医药》2020年第14期14-16,共3页China Practical Medicine

摘　　要：目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)水平与早发冠心病(PCHD)病变严重程度的相关性。方法245例疑诊冠心病患者,根据选择性冠状动脉造影(CAG)等结果分为PCHD组(145例)和对照组(CAG术结果未见异常或狭窄<50%者,100例);参考中华医学会心血管病学分会相关指南及CAG结果将PCHD组分为稳定型心绞痛(SAP)组(53例)、不稳定型心绞痛(UAP)组(58例)、急性心肌梗死(AMI)组(34例);依据CAG结果分为单支病变组(69例)、双支病变组(40例)、多支病变组(36例);根据标准化Gensini积分系统将PCHD组分为轻度组(评分<20分,69例)、中度组(20~60分,44例)、重度组(>60分,32例)。比较PCHD组与对照组临床资料,检测并比较PCHD组中不同病情、病变支数、Gensini评分患者的血浆Lp-PLA2水平。结果PCHD组与对照组的年龄、性别、吸烟史、高血压史、肌酐(Cr)、空腹血糖(FBG)、甘油三酯(TG)比较,差异均无统计学意义(P>0.05);PCHD组的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、Lp-PLA2水平均高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异均有统计学意义(P<0.05)。AMI组和UAP组患者的Lp-PLA2水平分别为(256.05±56.01)、(186.88±41.83)ng/ml,明显高于SAP组的(163.75±40.79)ng/ml,AMI组患者的Lp-PLA2高于UAP组,差异均具有统计学意义(P<0.05)。多支病变组的Lp-PLA2(253.04±50.91)ng/ml明显高于双支病变组的(195.58±35.54)ng/ml和单支病变组的(163.64±45.86)ng/ml,双支病变组的Lp-PLA2水平高于单支病变组,差异均具有统计学意义(P<0.05)。随着冠状动脉病变程度加重,即Gensini评分升高,血浆Lp-PLA2水平亦明显增加(P<0.05)。同时采用Spearman相关分析显示,PCHD患者Lp-PLA2水平与冠状动脉病变严重程度呈显著正相关(r=0.681,P<0.05)。结论PCHD患者血清Lp-PLA2显著高于非PCHD患者,且与冠心病严重程度呈正相关,血清Lp-PLA2的水平可用来评估PCHD患者病情的严重程度。Objective To discuss the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2)and the severity of premature coronary heart disease(PCHD).Methods A total of 245 patients with suspected coronary heart disease were divided into PCHD group(145 cases)and control group(no abnormality or stenosis<50%in CAG,100 cases)by selective coronary arteriography(CAG)results.According to related guidelines and CAG results of cardiovascular branch of Chinese Medical Association,PCHD group was divided into stable angina pectoris(SAP)group(53 cases),unstable angina pectoris(UAP)group(58 cases),acute myocardial infarction(AMI)group(34 cases).According to CAG results,PCHD group was divided into singlevessel disease group(69 cases),double-vessel disease group(40 cases),multi-vessel disease group(36 cases).According to the standardized Gensini integral system,PCHD group was divided into mild group(score<20 points,69 cases),moderate group(20-60 points,44 cases),severe group(>60 points,32 cases).The clinical data of PCHD group and control group was compared,and the plasma Lp-PLA2 levels of patients with different conditions,number of vessel disease,and Gensini scores in the PCHD group were detected and compared.Results There was no statistically significant difference in age,gender,history of smoking,history of hypertension,creatinine(CR),fasting blood glucose(FBG),triglyceride(TG)between PCHD group and the control group(P>0.05).The levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and Lp-PLA2 of PCHD group were higher than those of the control group,and high density lipoprotein cholesterol(HDL-C)level was lower than that of the control group,and the difference was statistically significant(P<0.05).Lp-PLA2 level of AMI group and UAP group were(256.05±56.01)and(186.88±41.83)ng/ml respectively,which were obviously higher than that of SAP group(163.75±40.79)ng/ml,and Lp-PLA2 level of AMI group was higher than that of UAP group,and the difference was statistically significant(P<0.05).Lp-PLA2 level(253.0

关 键 词：冠状动脉粥样硬化性心脏病 脂蛋白相关磷脂酶A2 冠状动脉病变数量 

分 类 号：R541.4[医药卫生—心血管疾病]