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冠心病血脂蛋白相关磷脂酶A2水平与冠脉病变的相关性研究

杨丽   

  1. 天津市胸科医院
  • 收稿日期:2011-02-24 修回日期:2011-04-13 出版日期:2011-08-15 发布日期:2011-08-15
  • 通讯作者: 杨丽

Study on Relationship between Plasma Lipoprotein-associated Phospholipase A2 and Coronary Atherosclerosis

  • Received:2011-02-24 Revised:2011-04-13 Published:2011-08-15 Online:2011-08-15

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摘要： 目的：探讨冠心病患者血脂蛋白相关磷脂酶A2（Lp-PLA2）水平与冠状动脉病变程度及斑块稳定性的关系。方法：将299例拟诊冠心病患者根据冠脉造影结果分为冠心病组（232例）和对照组（67例），冠心病患者再根据临床类型分为AMI组（46例）、UAP组（114例）、SAP组（72例）并计算冠脉Gensini积分, 检测其血浆Lp-PLA2水平及总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、脂蛋白a[Lp（a）]、纤维蛋白原（FIB）和C反应蛋白（CRP）水平并进行比较，分析LP-PLA2与冠心病及Gensini积分的关系。结果：冠心病组血浆Lp-PLA2水平高于对照组（P<0.01）；AMI组和UAP组患者Lp-PLA2水平高于SAP组（P<0.05），AMI组和UAP组之间差异无统计学意义；Lp-PLA2水平与LDL-C、CRP、 Gensini积分呈正相关，Lp-PLA2、高血压、LDL-C和Lp-a是冠心病的独立危险因素，HDL-C为保护因素，Gensini积分受年龄、Lp-PLA2、HDL-C和LDL-C的影响。结论：血Lp-PLA2升高是冠心病的独立危险因素之一，Lp-PLA2水平与冠脉病变严重程度及动脉粥样硬化斑块的稳定性相关。

关键词: 脂蛋白相关磷脂酶A2, 冠心病, Gensini积分, C反应蛋白

Abstract: Objective:To investigate wether plasma lipoprotein-associated phospholipase A2(Lp-PLA2) activity correlates with severity and stability of coronary atherosclerosis in coronary heart disease(CHD).Method:Coronary angiography (CAG) was performed in 299 patients who were suspected as having CHD.According to the result of CAG,the patients were divided into CHD group(n=232) and control group(n=67).The CHD group was further divided into subgroups according to the clinical types and Gensini scores of every patient was calculated. Lp-PLA2 activity and the levels of plasma total cholesterol(TC)，triglyceride(TG)，low density lipoprotein- cholesterol (LDL-C)，high density lipoprotein- cholesterol (HDL-C)，lipoprotien-a[Lp（a）]，fibrinogen(FIB) and C- reactive protein (CRP) were measured in all groups and the results were compared and analysed .Resultes:Plasma Lp-PLA2 activity in CHD group was higher than that in control group (P<0.01),and that was higher in the group of acute myocardial infarction(AMI) and the group of unstable angina pectoris(UAP)) than that in stable angina pectoris(SAP)(P<0.05).The comparison between AMI group and UAP group showed no statiscal significance.Plasma Lp-PLA2 level was positively correlated with LDL-C,CRP,and Gensini score .Level of Lp-PLA2 correlated independently to CHD. Lp-PLA2 ,hypertension, LDL-C and Lp（a）were independent risk factors of CHD,while HDL-C was a protective factor. Gensini score was effected on age, Lp-PLA2 , HDL-C and LDL-C .Conclusion: Lp-PLA2 is one of independent risk factors of CHD .The plasma level of Lp-PLA2 is related to the degree of coronary artery stenosis and the stability of coronary atherosclerosis.

Key words: lipoprotein-associatedphospholipase A2, coronary heart disease, Gensini score, C- reactive protein