CAJ | 학술논문

目的：评估血清脂蛋白相关磷脂酶A2（Lp-PLA2）与冠状动脉病变的相关性，探讨Lp-PLA2浓度的临床影响因素。方法对2012年9月至2014年7月行同时进行了Lp-PLA2浓度检测及冠状动脉CTA检查的250例患者进行回顾性分析，纳入分析患者190例。分析所有患者的临床指标、生化指标及冠状动脉CTA结果。结果冠状动脉病变组与冠状动脉正常组比较，Lp-PLA2浓度差异有统计学意义。临床上影响Lp-PLA2浓度的因素有性别、心力衰竭、LDL-C浓度。其中心力衰竭是影响Lp-PLA2浓度的最大因素。Lp-PLA2浓度与冠状动脉Gensini评分呈正相关关系。三支病变组Lp-PLA2浓度显著高于单支病变组。非钙化性斑块、混合斑块及钙化性斑块患者的Lp-PLA2浓度差异无统计学意义。结论冠状动脉病变患者的Lp-PLA2水平与冠状动脉病变的严重程度成正相关，但其水平受性别、心力衰竭及LDL-C的影响。
목적：평고혈청지단백상관린지매A2（Lp-PLA2）여관상동맥병변적상관성，탐토Lp-PLA2농도적림상영향인소。방법대2012년9월지2014년7월행동시진행료Lp-PLA2농도검측급관상동맥CTA검사적250례환자진행회고성분석，납입분석환자190례。분석소유환자적림상지표、생화지표급관상동맥CTA결과。결과관상동맥병변조여관상동맥정상조비교，Lp-PLA2농도차이유통계학의의。림상상영향Lp-PLA2농도적인소유성별、심력쇠갈、LDL-C농도。기중심력쇠갈시영향Lp-PLA2농도적최대인소。Lp-PLA2농도여관상동맥Gensini평분정정상관관계。삼지병변조Lp-PLA2농도현저고우단지병변조。비개화성반괴、혼합반괴급개화성반괴환자적Lp-PLA2농도차이무통계학의의。결론관상동맥병변환자적Lp-PLA2수평여관상동맥병변적엄중정도성정상관，단기수평수성별、심력쇠갈급LDL-C적영향。
Objective To explore the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and the severity of coronary stenosis and plaque stability and to investigate clinical determinants of Lp-PLA2 level. Methods Two hundred and fifty patients who underwent coronary computed tomography angiography (CTA) and Lp-PLA2 concentration detection between September 2012 and July 2014 were retrospectively analyzed. One hundred and ninety patients were included into the study, and divided into coronary artery disease group (CAD) (n=135) and normal group (n=55). Records of patients’ baseline characteristics (gender, age, height, body mass index and medications), results of coronary CTA, biochemical indicators (glycated hemoglobin, creatinine, total cholesterol, LDL-C) were analyzed. Results Lp-PLA2 concentration in CAD group was significantly higher than that in the normal group [(259.40±150.33)ng/ml vs. (183.24±142.27)ng/ml, P=0.002]. The influencing factors of Lp-PLA2 level were gender, heart failure and LDL-C concentration, and heart failure was the most important one. Lp-PLA2 concentration was positively correlated with coronary Gensini scores (P<0.01). Lp-PLA2 concentration in patients with triple coronary artery lesions was significantly higher than that in single vessel lesion (P<0.01). Conclusion The concentration of Lp-PLA2 is positively correlated with the severity of coronary artery lesion, and it is affected by gender, heart failure and LDL-C concentration.