CAJ | 학술논문

目的：探讨临床中血浆脂蛋白相关磷脂酶A2(Lp-PLA2)活性与冠脉病变程度和冠心病的相关性。方法选取高州市人民医院心血管内科2012年1月~2013年6月60例冠心病患者为研究组，同期60例行冠状动脉造影术(CAG)未见有冠状动脉狭窄的患者为对照组，并将研究组中冠心病的临床类型和冠脉病变支数以及Gensini积分分为不同亚组。采取ELISA法测定Lp-PLA2水平。结果研究组中稳定型心绞痛、不稳定型心绞痛、心肌梗死患者的Lp-PLA2活性分别为(26.32±0.77)、(29.14±0.42)、(32.21±0.78)μmol/(min·mL)，均明显高于对照组[(21.32±1.56)μmol/(min·mL)]，差异有统计学意义(P<0.05)；且稳定型心绞痛、不稳定型心绞痛、心肌梗死患者的Lp-PLA2活性比较差异也有统计学意义(P<0.05)。研究组中单支病变和双支病变以及三支病变的Lp-PLA2活性分别为(26.13±1.45)、(28.78±1.36)、(31.67±1.47)μmol/(min·mL)，均明显高于对照组[(21.32±1.56)μmol/(min·mL)]，差异有统计学意义(P<0.05)；且单支病变和双支病变以及三支病变患者的Lp-PLA2活性比较差异也有统计学意义(P<0.05)。研究组中0~<20分和20~<40分以及≥40分的Lp-PLA2活性分别为(26.07±1.32)、(28.71±1.27)、(31.78±1.41)μmol/(min·mL)，均明显高于对照组[(21.32±1.56)μmol/(min·mL)]，差异有统计学意义(P<0.05)；且0~<20分和20~<40分以及≥40分患者的Lp-PLA2活性比较差异也有统计学意义(P<0.05)。结论 Lp-PLA2与冠心病的发生具有一定的联系，对该病的预测具有一定的意义。同时，该指标活性能够有效地反映出冠状动脉硬化的病变程度。
목적：탐토림상중혈장지단백상관린지매A2(Lp-PLA2)활성여관맥병변정도화관심병적상관성。방법선취고주시인민의원심혈관내과2012년1월~2013년6월60례관심병환자위연구조，동기60례행관상동맥조영술(CAG)미견유관상동맥협착적환자위대조조，병장연구조중관심병적림상류형화관맥병변지수이급Gensini적분분위불동아조。채취ELISA법측정Lp-PLA2수평。결과연구조중은정형심교통、불은정형심교통、심기경사환자적Lp-PLA2활성분별위(26.32±0.77)、(29.14±0.42)、(32.21±0.78)μmol/(min·mL)，균명현고우대조조[(21.32±1.56)μmol/(min·mL)]，차이유통계학의의(P<0.05)；차은정형심교통、불은정형심교통、심기경사환자적Lp-PLA2활성비교차이야유통계학의의(P<0.05)。연구조중단지병변화쌍지병변이급삼지병변적Lp-PLA2활성분별위(26.13±1.45)、(28.78±1.36)、(31.67±1.47)μmol/(min·mL)，균명현고우대조조[(21.32±1.56)μmol/(min·mL)]，차이유통계학의의(P<0.05)；차단지병변화쌍지병변이급삼지병변환자적Lp-PLA2활성비교차이야유통계학의의(P<0.05)。연구조중0~<20분화20~<40분이급≥40분적Lp-PLA2활성분별위(26.07±1.32)、(28.71±1.27)、(31.78±1.41)μmol/(min·mL)，균명현고우대조조[(21.32±1.56)μmol/(min·mL)]，차이유통계학의의(P<0.05)；차0~<20분화20~<40분이급≥40분환자적Lp-PLA2활성비교차이야유통계학의의(P<0.05)。결론 Lp-PLA2여관심병적발생구유일정적련계，대해병적예측구유일정적의의。동시，해지표활성능구유효지반영출관상동맥경화적병변정도。
Objective To explore the correlation of the activity of plasma lipoprotein associated phospholipids A2 (Lp-PLA2) with the severity of coronary artery lesions and coronary heart disease in clinic. Methods 60 cases of patients with coronary heart disease in Department of Cardiovascular Medicine in the People's Hospital of Gaozhou from Jan-uary 2012 to June 2013 were chosen as study group, in the same period, 60 cases of patients without coronary artery stenosis detected by CAG were as control group. The clinical types of coronary heart disease, the number of coronary artery lesions and Gensini scores in the study group were divided into different subgroups. The level of Lp-PLA2 was detected by ELISA method. Results The activities of Lp-PLA2 of stable angina, unstable angina, myocardial infarction in study group were (26.32±0.77), (29.14±0.42), (32.21±0.78) μmol/(min·mL), which were significantly higher than that in the control group [(21.32±1.56) μmol/(min·mL)], the differences were statistically significant (P<0.05);and the Lp-PLA2 activities of stable angina, unstable angina, myocardial infarction also had significant differences (P< 0.05). The activities of Lp-PLA2 of single vessel lesion and double branch lesions and three lesions in the study group were (26.13±1.45), (28.78±1.36), (31.67±1.47) μmol/(min·mL), which were significantly higher than that in the control group [(21.32±1.56) μmol/(min·mL)], the differences were statistically significant (P< 0.05); and the Lp-PLA2 activities of the single branch lesion and double branch lesions and three lesions also had significant differences (P< 0.05). The activities of Lp-PLA2 of 0-<20 scores, 20-<40 scores and ≥40 scores in the study group were (26.07±1.32), (28.71±1.27), (31.78±1.41) μmol/(min·mL), which were signifi-cantly higher than that in the control group [(21.32±1.56) μmol/(min·mL)], the differences were statistically significant (P < 0.05), and the Lp-PLA2 activities of 0-<20 scores, 20-<40 scores and ≥40 scores also had statistically significant differences (P< 0.05). Conclusion Lp-PLA2 has a connection with the occurence of coronary heart disease, which has a certain significance for the prediction of the disease. At the same time, the activity of this index can effectively reflect the severity of coronary atherosclerosis.