冠心病患者分泌型磷脂酶A2、sOX40L的变化水平及与冠状动脉病变的相关性

Secretory type Ⅱ phospholipase A2 and sOX40L levels and their correlations to severity of coronary lesion in acute coronary syndrome

目的探讨人血液分泌型磷脂酶A2(sPLA2)和sOX40L水平与冠心病及冠状动脉病变严重程度和稳定性的关系。方法根据临床表现、心电图、心肌酶检测和冠状动脉造影结果确诊冠心病患者67例(冠心病组),非冠心病患者21例(非冠心病组)。分别组成冠心病组和对照组。冠心病患者再分别根据临床类型、冠状动脉病变支数、Gensini积分进行分组。所有患者在造影前均测定sPLA2和sOX40L水平、血脂等指标。结果冠心病患者sPLA2(67.80±16.82)kU/L和sOX40L(226.35±69.06)ng/L显著高于对照组sPLA2(54.78±11.75)kU/L和sOX40L(155.97±52.48)ng/L(均P<0.01)。急性冠状动脉综合征组患者sPLA2(69.70±16.02)kU/L和sOX40L(275.63±89.06)ng/L均显著高于稳定型心绞痛组sPLA2(61.59±11.64)kU/L,sOX40L(162.34±34.46)ng/L(均P<0.01);sPLA2与sOX40L呈正相关(r=0.632,P<0.05)。sPLA2和sOX40L水平随着冠状动脉病变支数和Gensini积分的增加而升高。结论sPLA2和sOX40L水平能反映冠状动脉粥样硬化病变的严重程度,与冠状动脉病变稳定性相关。

Objective To explore whether secretory type Ⅱ phospholipase A2 （sPLA2） and sOX40L levels correlate with coronary heart disease （CHD） and severity and stability of coronary atherosclerosis. Methods According to clinical manifestation, electrocardiogram, myocardium enzyme and coronary angiography, 67 persons were enrolled as coronary heart disease（CHD.） group,21 non-CHD patients as control group. The CHD patients were further divided into subgroups according to the clinical types,the number of diseased coronary branches and Gensini score, sPLA2 and sOX40L levels,lipids were measured. Results sPLA2 level （67.80±16.82） kU/L and sOX40L level （226.35±69.06） ng/L in CHD patients, which were significantly higher than those in controls, sPLA2 （54.78±11.75） kU/L, sOX40L （155.97±52.48） ng/L（all P 〈0.01）. The level of sPLA2 （69.70±16.02） kU/L and sOX40L （275.63±89.06） ng/L in patients with acute coronary syndrome, all were significantly higher than those in patients with stable angina pectoris,sPLA2 （61.59±11.64） kU/L,sOX40L （162.34±34.46） ng/L （all P 〈0.01）. The changes of sPLA2 and sOX40L were positively correlated （ r= 0. 632, P 〈0.05）. sPLA2 and sOX40L levels increased with the increasing number of diseased coronary branches and Gensini score. Conclusion sPLA2 and sOX40L level can be used as a parameter to predict pathological severity of coronary atherosclerosis, and the stability of pathological changes of the coronary artery.