中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2010年
7期
645-648
,共4页
汪俊军%韩爱忠%宫剑宾%张春妮%李克
汪俊軍%韓愛忠%宮劍賓%張春妮%李剋
왕준군%한애충%궁검빈%장춘니%리극
急性冠状动脉综合征%脂蛋白(a)%自身抗体
急性冠狀動脈綜閤徵%脂蛋白(a)%自身抗體
급성관상동맥종합정%지단백(a)%자신항체
Acute coronary syndrome%Lipoprotein(a)%Autoantibodies
目的 研究PCI治疗对ACS患者脂蛋白(a)[Lp(a)]、氧化脂蛋白(a)[ox-Lp(a)]水平的影响和机制.方法 收集75例ACS患者PCI前、后、24 h、2 d、3 d和6个月后各时间点,以及29例未行PCI术的对照组冠状动脉造影前、后血标本;采用ELISA法测定Lp(a)、OX-Lp(a)、Lp(a)免疫复合物[Lp(a)-IC]和自身抗体水平;冠状动脉造影确认病变程度.手术前后各指标的变化采用配对t检验;PCI前、后不同时间点Lp(a)、ox-Lp(a)相对变化值间比较采用方差分析;Lp(a)与ox-Lp(a)、冠状动脉病变程度与Lp(a)、ox-Lp(a)变化值间相关性采用直线相关分析.结果 PCI术后Lp(a)水平[233.10(152.86～328.79)mg/L]高于术前[202.05(106.15～271.42)mg/L],差异有统计学意义(数据经对数转换后分析,t=6.81,P<0.01);PCI术后ox-Lp(a)[19.05(10.98～31.80)mg/L]与术前[10.51(4.98～17.97)mg/L]相比升高,差异有统计学意义(数据经对数转换后分析,t=13.22,P<0.01);PCI术后Lp(a)-IC[2.72(1.60～4.91)AU]与术前[2.11(1.04～3.97)AU]相比升高,差异有统计学意义(数据经对数转换后分析,t=3.34,P<0.01);而PCI术后自身抗体(A=0.81±0.33)与术前(A=0.72±0.28)相比降低,差异有统计学意义(t=5.58,P<0.01).PCI前(r=0.66,P<0.01)、后(r=0.62,P<0.01)ox-Lp(a)水平均与Lp(a)高度相关.PCI导致Lp(a)、ox-Lp(a)水平急速升高,24 h内快速下降,2～3 d内接近术前水平.Lp(a)、ox-Lp(a)变化值均与冠状动脉病变程度呈正相关.对照组造影前后Lp(a)、ox-Lp(a)、Lp(a)-IC和Lp(a)自身抗体水平均无变化.结论 PCI导致ACS患者Lp(a)、ox-Lp(a)水平升高,其增加值与冠状动脉病变程度相关.
目的 研究PCI治療對ACS患者脂蛋白(a)[Lp(a)]、氧化脂蛋白(a)[ox-Lp(a)]水平的影響和機製.方法 收集75例ACS患者PCI前、後、24 h、2 d、3 d和6箇月後各時間點,以及29例未行PCI術的對照組冠狀動脈造影前、後血標本;採用ELISA法測定Lp(a)、OX-Lp(a)、Lp(a)免疫複閤物[Lp(a)-IC]和自身抗體水平;冠狀動脈造影確認病變程度.手術前後各指標的變化採用配對t檢驗;PCI前、後不同時間點Lp(a)、ox-Lp(a)相對變化值間比較採用方差分析;Lp(a)與ox-Lp(a)、冠狀動脈病變程度與Lp(a)、ox-Lp(a)變化值間相關性採用直線相關分析.結果 PCI術後Lp(a)水平[233.10(152.86～328.79)mg/L]高于術前[202.05(106.15～271.42)mg/L],差異有統計學意義(數據經對數轉換後分析,t=6.81,P<0.01);PCI術後ox-Lp(a)[19.05(10.98～31.80)mg/L]與術前[10.51(4.98～17.97)mg/L]相比升高,差異有統計學意義(數據經對數轉換後分析,t=13.22,P<0.01);PCI術後Lp(a)-IC[2.72(1.60～4.91)AU]與術前[2.11(1.04～3.97)AU]相比升高,差異有統計學意義(數據經對數轉換後分析,t=3.34,P<0.01);而PCI術後自身抗體(A=0.81±0.33)與術前(A=0.72±0.28)相比降低,差異有統計學意義(t=5.58,P<0.01).PCI前(r=0.66,P<0.01)、後(r=0.62,P<0.01)ox-Lp(a)水平均與Lp(a)高度相關.PCI導緻Lp(a)、ox-Lp(a)水平急速升高,24 h內快速下降,2～3 d內接近術前水平.Lp(a)、ox-Lp(a)變化值均與冠狀動脈病變程度呈正相關.對照組造影前後Lp(a)、ox-Lp(a)、Lp(a)-IC和Lp(a)自身抗體水平均無變化.結論 PCI導緻ACS患者Lp(a)、ox-Lp(a)水平升高,其增加值與冠狀動脈病變程度相關.
목적 연구PCI치료대ACS환자지단백(a)[Lp(a)]、양화지단백(a)[ox-Lp(a)]수평적영향화궤제.방법 수집75례ACS환자PCI전、후、24 h、2 d、3 d화6개월후각시간점,이급29례미행PCI술적대조조관상동맥조영전、후혈표본;채용ELISA법측정Lp(a)、OX-Lp(a)、Lp(a)면역복합물[Lp(a)-IC]화자신항체수평;관상동맥조영학인병변정도.수술전후각지표적변화채용배대t검험;PCI전、후불동시간점Lp(a)、ox-Lp(a)상대변화치간비교채용방차분석;Lp(a)여ox-Lp(a)、관상동맥병변정도여Lp(a)、ox-Lp(a)변화치간상관성채용직선상관분석.결과 PCI술후Lp(a)수평[233.10(152.86～328.79)mg/L]고우술전[202.05(106.15～271.42)mg/L],차이유통계학의의(수거경대수전환후분석,t=6.81,P<0.01);PCI술후ox-Lp(a)[19.05(10.98～31.80)mg/L]여술전[10.51(4.98～17.97)mg/L]상비승고,차이유통계학의의(수거경대수전환후분석,t=13.22,P<0.01);PCI술후Lp(a)-IC[2.72(1.60～4.91)AU]여술전[2.11(1.04～3.97)AU]상비승고,차이유통계학의의(수거경대수전환후분석,t=3.34,P<0.01);이PCI술후자신항체(A=0.81±0.33)여술전(A=0.72±0.28)상비강저,차이유통계학의의(t=5.58,P<0.01).PCI전(r=0.66,P<0.01)、후(r=0.62,P<0.01)ox-Lp(a)수평균여Lp(a)고도상관.PCI도치Lp(a)、ox-Lp(a)수평급속승고,24 h내쾌속하강,2～3 d내접근술전수평.Lp(a)、ox-Lp(a)변화치균여관상동맥병변정도정정상관.대조조조영전후Lp(a)、ox-Lp(a)、Lp(a)-IC화Lp(a)자신항체수평균무변화.결론 PCI도치ACS환자Lp(a)、ox-Lp(a)수평승고,기증가치여관상동맥병변정도상관.
Objective To investigate possible changes of lipoprotein(a) [Lp(a)] and oxidized Lp (a) [ox-Lp(a) ] levels after PCI and it mechanisms. Methods Bloods were selected from 75 patients with ACS undergoing PCI, and at 24 hours, 2 and 3 days, and 6 months pre-and post-PCI treatment, and from 29 control patients pre-and post-coronary angiography without undergoing PCI. The levels of Lp(a) , ox-Lp(a) , Lp(a) immune complexes (IC) and its autoantibody were determined by ELISA. The extents of CAD were determined by coronary angiography. The differences of variants pre-and post-operations were analyzed by paired samples t test. The differences of levels of Lp(a) and ox-Lp(a) among time points after PCI were analyzed by ANOVA. Correlations between Lp(a) and ox-Lp(a) , and between angiographic variables and Lp(a), ox-Lp(a) levels were calculated. Results Compared to pre-PCI, Lp(a) [233.10 (152.86-328.79) mg/L vs 202.05 (106.15-271.42) mg/L, t=6. 81, P<0.01], ox-Lp(a) [19.05 (10.98-31.80) mg/L vs 10. 51 (4.98-17.97) μg/ml, t = 13. 22,P <0. 01] and Lp(a)-IC [2.72 (1.604.91) AU vs 2. 11 (1.04-3. 97) AU, t = 3. 34, P < 0. 01 ] levels significantly increased immediately in post-PCI, while its antoantibody levels significantly decreased (A = 0. 81 ± 0. 33 vs A = 0. 72 ± 0. 28, t = 5.58, P < 0. 01). Strong correlations were noted between levels of ox-Lp( a) and Lp( a) both in pre-PCI (r =0. 66, P <0.01) and post-PCI (r = 0. 62, P <0. 01). PCI resulted in rapidrise of Lp(a) and ox-Lp(a) levels and then decreased quickly in 24 hours, returned to baseline in 2-3 days. The changes of Lp(a) and ox-Lp(a) levels in pre-and post-PCI were positively related with severity of ACS. In contrast, in the angiography-only control group, no significant changes were noted in Lp(a) , ox-Lp(a) , Lp(a)-IC and Lp(a) autoantibodies levels between the pre-and post-angiography samples. Conclusion PCI results in acute plasma acute increases of levels of Lp(a) and ox-Lp(a) ,and the changes are related with lesion severity of the coronary artery.
