冠心病患者血清抗氧化型低密度脂蛋白抗体水平与临床表现的关系

Relationship between the Titer of Antibodies to Oxidized Low Density and the Clinic Manifestation in Atherosclerosis Patients

目的 探讨冠心病患者外周血抗氧化型低密度脂蛋白抗体水平的临床意义.方法 研究对象按照临床表现分为稳定型心绞痛组、不稳定型心绞痛组、急性心肌梗死组和对照组.酶联免疫吸附法测定血清中IgG型抗氧化型低密度脂蛋白抗体水平.Gemini评分对患者的冠状动脉狭窄程度进行定量测定.结果 冠心病患者抗氧化型低密度脂蛋白抗体水平显著高于对照组,以急性冠状动脉综合征患者尤为显著,抗氧化型低密度脂蛋白抗体升高具有延迟效应,以入院后7～10天的水平最高,各组之间的差异明显.冠心痛患者冠状动脉狭窄程度在各组之间差异无显著性.抗氧化型低密度脂蛋白抗体水平与冠状动脉狭窄程度之间无显著相关性.结论 抗氧化型低密度脂蛋白抗体水平在不同冠心病临床类型之间存在显著差异,提示自身免疫在动脉粥样硬化疾病的转归中发挥重要作用.抗氧化型低密度脂蛋白抗体有望成为独立于冠状动脉狭窄程度外的评估动脉粥样硬化风险的指标.

Aim To evaluate the clinic significance of antibodies to oxidized low density lipoprotein （ox-LDL） in the patients cf coronary artery disease （CHD）. Method The target population was divided into four groups by his clinic syndrome： stable angina pectoris （SAP） ; unstable angina pectoris （ UAP） ; acute myocardium infarction （ AMI） ; normal control group （CON）. Antibodies to ox-LDL in serum of the patients was measured by enzyme linked immunosorbent assay（ELISA）. The stenosis degree of coronary artery was quantitative assayed by Gemini marker. Results The fitre of antibodies to ox-LDL in the patients of CHD was obviously higher, especially in the ACS, than that in CON. The titre increased in hysteretic mode, which was highest 7 - 10 days after hospitalization and was most obviously different between groups. There was no statistical dependance between the fiter of antibodies and the stenosis degree of coronary artery. Conclusion There is a positive correlation between the titer of antibodies to ox-LDL and the clinical manifestation of CHD, which reveals that autoimmunity may play an important role in the origin, progress of atberosclerosis （As）. And the titer of antibodies to ox-LDL is hoped to be an important marker to evaluate the risk of As.