不稳定型心绞痛急性心肌梗死患者血清磷脂变化的临床意义  

Clinical significance of serum phospholipid changes in unstable angina pectoris and acute myocardial infarction

作　　者：魏晓真[1] 吕凤英[2] 胡婷婷[3] 阎西艴[4] 

机构地区：[1]郑州大学第三附属医院内科,河南郑州450052 [2]郑州市第一人民医院心内科 [3]郑州市第二人民医院心内科 [4]郑州大学第一附属医院心内科

出　　处：《中国急救医学》2003年第5期304-306,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的　观察血清磷脂酰胆碱 (PC)、磷脂酰丝氨酸 (PS)、磷脂酰乙醇氨 (PE)、磷脂酰肌醇 (PI)在不稳定型心绞痛(UAP)、急性心肌梗死 (AMI)、稳定型心绞痛 (SAP)患者中的变化 ,以早期发现、监测UAP和预测AMI的实验室指标。方法　将116例冠心病 (CHD)患者分为UAP组 60例、AMI组 41例、SAP组 15例 ,正常对照组 5 0例。抽取心绞痛发作或AMI发病 2 4h内空腹静脉血。利用高效液相色谱法测定血清中PC、PS、PE、PI的含量。并追踪随访心绞痛患者 6～ 18个月。结果　①UAP组的PC明显高于SAP组和对照组 (均 P =0 0 0 0 1) ;AMI组的PC明显高于SAP组和对照组 (P =0 0 0 0 7,P =0 0 0 0 1)。②UAP组的PS明显高于AMI组、SAP组和对照组 (均P =0 0 0 0 1)。③UAP组的PE明显高于AMI组、SAP组和对照组 (P =0 0 0 2 5 ,P=0 0 0 15 ,P =0 0 0 0 1)。④UAP组的PC +PS明显高于AMI组、SAP组和对照组 (P =0 0 0 15 ,P =0 0 0 0 1,P =0 0 0 0 1) ;AMI组的PC +PS明显高于对照组 (P =0 0 0 0 1)。结论　UAP的诊断除临床表现、心电图改变等条件外 ,血清PC >1 0mg/mL ,同时伴有 (或只有 )PS >0 4mg/mL ,PE >0 0 8mg/mL ,可能作为辅助诊断的参考条件。在UAP治疗过程中 ,血清PC >1 15mg/mL ,PS >0 45mg/mL ,应视为UAP病情仍?Objective This research focused on changes of the serum phospholipid including phosphatidylcholine(PC), phosphatidyl serine(PS),phosphatidylethanolamine(PE) and phosphatidylinositol(PI) in the patients suffering from unstable angina pectoris(UAP), acute myocardial infarction(AMI)and stable angina pectoris(SAP).The main purpose was to find out whether the value of serum paospholipid could be used as a criteria for diagnosis of UAP and prediction of AMI.Methods 116 cases of hospitalized CHD patients were divided into 3 groups:60 patients in the group of UAP;41 in the group of AMI;15 in the group of SAP;50 normal persons in the control group.Blood sample in fasting of UAP, AMI and SAP patients were collected within 24 hours after the heart attack.The concentration values of the serum phospholipids were measured by the method of high performance liquid chromatography.Angina pectoris(AP) patients followed up for 6～18 months.Results The results showed that ①The level of PC was significantly higher in UAP than that in SAP or control(P=0.0001,P=0.0001);the level of PC was significantly higher in AMI than that in SAP or control(P=0.0007,P=0.0001).②The level of PS was significantly higher in UAP than that in AMI,SAP or control(P=0.0001,P=0.0001,P=0.0001).③The level of PE was significantly higher in UAP than that in AMI,SAP or control(P=0.0025,P=0.0015,P=0.0001).④The level of PC plus PS was significantly higher in UAP than that in AMI,SAP or control(P=0.0015,P=0.0001,P=0.0001);the level of PC plus PS was significantly higher in AMI than that in control (P=0.0001).Conclusions Results indicated that levels of serum PC>1.0 mg/mL,when(or only) PS>0.4 mg/mL, PE>0.08 mg/mL might be another condition of UAP diagnosis,except for the symptoms of clinical and electrocardiogram.In the treatment of UAP,it was known as a progress of UAP state when serum PC>1.15 mg/mL, PS>0.45 mg/mL.The doctor should strengthen the treatment of UAP to prevent AMI.It prompted a bad prognosis when serum PC>1.2 mg/mL, PS>0.8 mg/mL, PE>0.09 mg/

关 键 词：不稳定型心绞痛 急性心肌梗死 血清磷脂 高效液相色谱法 

分 类 号：R541.4[医药卫生—心血管疾病] R542.22[医药卫生—内科学]