临床荟萃
臨床薈萃
림상회췌
Clinical Focus
2015年
12期
1371-1374
,共4页
崔旭丹%尹力%袁如玉%崔占前
崔旭丹%尹力%袁如玉%崔佔前
최욱단%윤력%원여옥%최점전
冠心病%脂蛋白相关磷脂酶 A2
冠心病%脂蛋白相關燐脂酶 A2
관심병%지단백상관린지매 A2
coronary heart disease%lipoprotein-associated phospholipase A2
目的：探讨临床中血浆脂蛋白相关磷脂酶 A2(Lp-PLA2)与冠状动脉病变程度及冠状动脉斑块形态的相关性。方法入选研究对象266例,其中急性冠状动脉综合征(ACS)患者140例,分为心绞痛组78例、急性心肌梗死组62例；对照组126例为同期行冠状动脉造影术示冠状动脉狭窄<50%的患者。根据造影结果对冠状动脉狭窄程度进行 Gensini 评分,并对冠状动脉病变形态进行分型。所有对象均检测 Lp-PLA2及超敏 C 反应蛋白(hs-CRP)。结果心绞痛组、急性心肌梗死组的 Lp-PLA2水平分别为(257.41±89.06)μg/L、(332.02±61.62)μg/L,均高于对照组(225.15±71.26)μg/L,差异有统计学意义(P <0.05),急性心肌梗死组 Lp-PLA2水平高于心绞痛组,差异有统计学意义(P <0.01)；Ⅱ、Ⅲ型病变患者平均血清 hs-CRP、LP-PLA2水平显著高于Ⅰ型病变者(12.55±16.34)mg/L、(18.20±35.16)mg/L,(326.46±56.32)μg/L、(307.05±84.51)μg/L vs (4.49±9.40)mg/L,(256.96±97.73)μg/L(P <0.01),但Ⅱ型病变与Ⅲ型病变患者血清 hs-CRP、LP-PLA2水平之间差异无统计学意义。经双变量相关性分析,血浆 Lp-PLA2水平与 hs-CRP、Gensini 积分水平均呈正相关(r =0.277,P <0.01；r =0.174,P <0.01)。结论 Lp-PLA2可反应冠心病的炎症活动情况及斑块的不稳定性,与冠状动脉病变的严重程度成正相关。
目的：探討臨床中血漿脂蛋白相關燐脂酶 A2(Lp-PLA2)與冠狀動脈病變程度及冠狀動脈斑塊形態的相關性。方法入選研究對象266例,其中急性冠狀動脈綜閤徵(ACS)患者140例,分為心絞痛組78例、急性心肌梗死組62例；對照組126例為同期行冠狀動脈造影術示冠狀動脈狹窄<50%的患者。根據造影結果對冠狀動脈狹窄程度進行 Gensini 評分,併對冠狀動脈病變形態進行分型。所有對象均檢測 Lp-PLA2及超敏 C 反應蛋白(hs-CRP)。結果心絞痛組、急性心肌梗死組的 Lp-PLA2水平分彆為(257.41±89.06)μg/L、(332.02±61.62)μg/L,均高于對照組(225.15±71.26)μg/L,差異有統計學意義(P <0.05),急性心肌梗死組 Lp-PLA2水平高于心絞痛組,差異有統計學意義(P <0.01)；Ⅱ、Ⅲ型病變患者平均血清 hs-CRP、LP-PLA2水平顯著高于Ⅰ型病變者(12.55±16.34)mg/L、(18.20±35.16)mg/L,(326.46±56.32)μg/L、(307.05±84.51)μg/L vs (4.49±9.40)mg/L,(256.96±97.73)μg/L(P <0.01),但Ⅱ型病變與Ⅲ型病變患者血清 hs-CRP、LP-PLA2水平之間差異無統計學意義。經雙變量相關性分析,血漿 Lp-PLA2水平與 hs-CRP、Gensini 積分水平均呈正相關(r =0.277,P <0.01；r =0.174,P <0.01)。結論 Lp-PLA2可反應冠心病的炎癥活動情況及斑塊的不穩定性,與冠狀動脈病變的嚴重程度成正相關。
목적：탐토림상중혈장지단백상관린지매 A2(Lp-PLA2)여관상동맥병변정도급관상동맥반괴형태적상관성。방법입선연구대상266례,기중급성관상동맥종합정(ACS)환자140례,분위심교통조78례、급성심기경사조62례；대조조126례위동기행관상동맥조영술시관상동맥협착<50%적환자。근거조영결과대관상동맥협착정도진행 Gensini 평분,병대관상동맥병변형태진행분형。소유대상균검측 Lp-PLA2급초민 C 반응단백(hs-CRP)。결과심교통조、급성심기경사조적 Lp-PLA2수평분별위(257.41±89.06)μg/L、(332.02±61.62)μg/L,균고우대조조(225.15±71.26)μg/L,차이유통계학의의(P <0.05),급성심기경사조 Lp-PLA2수평고우심교통조,차이유통계학의의(P <0.01)；Ⅱ、Ⅲ형병변환자평균혈청 hs-CRP、LP-PLA2수평현저고우Ⅰ형병변자(12.55±16.34)mg/L、(18.20±35.16)mg/L,(326.46±56.32)μg/L、(307.05±84.51)μg/L vs (4.49±9.40)mg/L,(256.96±97.73)μg/L(P <0.01),단Ⅱ형병변여Ⅲ형병변환자혈청 hs-CRP、LP-PLA2수평지간차이무통계학의의。경쌍변량상관성분석,혈장 Lp-PLA2수평여 hs-CRP、Gensini 적분수평균정정상관(r =0.277,P <0.01；r =0.174,P <0.01)。결론 Lp-PLA2가반응관심병적염증활동정황급반괴적불은정성,여관상동맥병변적엄중정도성정상관。
ABSTRACT:Objective To investigate the clinical plasma lipoprotein-associated phospholipase A2 (Lp-PLA2 ) and extent of coronary artery disease and coronary plaque morphology correlation.Methods 266 subjects included 140 patients with acute coronary syndrome (ACS),in which 78 patients with angina pectoris and 62 with acute myocardial infarction.In control group,126 cases for the same period underwent coronary angiography which showed coronary artery stenosis <50%.Coronary artery stenosis was characterized by Gensini scores,coronary lesions morphology was classified into different types. Lp-PLA2 and high-sensitivity C-reactive protein (hs-CRP ) were measured in all patients.Results Lp-PLA2 level in angina pectoris and acute myocardial infarction group was higher than that in control group (257.41 ± 89.06 )μg/L,(332.02 ± 61.62 )μg/L vs (225.1 5 ± 71.26 )μg/L (P < 0.05 ),Lp-PLA2 concentration was higher in acute myocardial infarction group than that in angina group(P <0.01 ).Serum hs-CRP and LP-PLA2 level in type Ⅱ,Ⅲ group were significantly higher than those in type Ⅰ group (12.55±1 6.34)mg/L, (18.20±35.1 6)mg/L,(326.46±56.32 )μg/L,(307.05 ± 84.5 1 )μg/L vs (4.49 ± 9.40)mg/L,(256.96 ± 97.73 )μg/L(P < 0.001 ),but serum hs-CRP,LP-PLA2 level between type Ⅱ group and Ⅲ lesions group meant no statistical difference.By bivariate correlation analysis,plasma level of Lp-PLA2 was positive correlated with hs-CRP and Gensini scores (r =0.277,P <0.001;r =0.1 74,P <0.01).Conclusion Lp-PLA2 may react inflammation and plaque instability of coronary heart disease,and it was positive correlated with the severity of coronary artery disease.
