急性、非急性冠状动脉病变患者血浆氧化低密度脂蛋白的变化

Changes of serum oxidized low-density lipoprotein in patients with acute and non-acute coronary artery disease

目的探讨冠心病患者氧化型低密度脂蛋白(ox-LDL)的变化及机制,评估ox-LDL水平检测的临床价值。方法采用ELISA法测定139例冠心病组患者[急性冠状动脉综合征(ACS)76例,非ACS组63例]和100例健康对照组人群血浆ox-LDL水平;根据冠状动脉造影结果将冠心病组分为多支病变组、双支病变组和单支病变组进行比较分析。结果ACS组患者和非ACS组患者ox-LDL水平均显著高于健康对照组[ACS:(188.01±69.88)μg/ml,非ACS:(137.88±59.74)μg/ml,对照组:(82.68±29.06)μg/ml;P均<0.001];且ACS组患者ox-LDL水平显著高于非ACS组患者(P<0.001)。冠状动脉多支、双支、单支病变组间ox-LDL水平不同[(183.63±79.42)μg/ml,(164.15±63.79)μg/ml和(146.97±58.40)μg/ml,P<0.05],多支高于单支(P<0.01)。多因素分析显示冠状动脉病变程度仅与ox-LDL相关(R2=0.048,β=0.217,P=0.000)。结论冠心病患者ox-LDL水平升高,与病变程度相关,急性冠脉综合征患者变化尤为显著。

Objective To explore the changed mechanism of plasma oxidized low-density lipoprotein （ox-LDL） in the patients with coro- nary heart disease, and to evaluate the clinical value of detection for ox-LDL level. Methods Enzyme-linked immunosorbent assay （ELISA） was used to measure the plasma ox-LDL in 139 patients with coronary heart disease, among them 76 were acute coronary syn- drome （ACS） and 63 were non-ACS patients, and in 100 healthy controls. The patients were divided by coronary angiography into multi-vessel disease group, double-vessel disease group and mono-vessel disease group. Results The ox-LDL levels of the patients in both ACS and non-ACS groups[ （188.01±69.88）μg/ml and （137.88±59.74） μg/ml] were significantly higher than that in nor- mal controls group[ （82.68 ± 29.06 ） μg/ml ;P 〈 O. 001 ], and the ox-LDL level of patients in ACS group was significantly higher than that in non-ACS group （ P 〈0. 001 ）. Different plasma levels of ox-LDL were found in the multi-vessel, double-vessel and mono-vessel disease group [ （ 183.63± 79.42） μg/ml, （ 164.15± 63.79） μg/ml, and （ 146.97 ± 58.40） μg/ml, respectively, P 〈 0.05 ]. The ox-LDL levels in multi-vessel disease group were significantly higher than that in mono-vessel group （ P 〈 0.01 ）. Multiple linear re- gression analysis showed that ox-LDL levels significantly correlated with the severity of coronary artery disease （ R2 = 0. 100,13 = 0. 316 ,P =0.000）. Conclusion Elevated levels of ox-LDL presented in the patients with coronary heart disease and correlated with the severity of coronary artery lesion, especially in the patients with acute coronary syndrome.