血清ω-3多不饱和脂肪酸与急性冠状动脉综合征的临床关系研究

Study on relationship between acute coronary syndrome and serum omega-3 polyunsaturated fatty acids

目的探讨急性冠状动脉综合征(ACS)患者血清ω-3多不饱和脂肪酸(ω-3PUFA:十八碳三烯酸,ALA;二十碳五烯酸,EPA;二十二碳六烯酸,DHA)的含量变化及其与冠状动脉病变支数之间的关系。方法120例冠脉造影患者分为对照组和ACS组。根据冠状动脉造影结果将ACS组分为单支病变(SVD)组和多支病变(MVD)组。应用气相色谱/质谱(GC/MS)法测定血清ω-3PUFA含量。结果①ACS组血清EPA和DHA含量较对照组明显下降(P<0.05,P<0.01),两组ALA含量差异无统计学意义(P>0.05)。②MVD组和SVD组患者血清EPA和DHA含量均低于对照组(P<0.05),但MVD组和SVD组EPA和DHA含量差异无统计学意义(P>0.05),各组ALA含量差异无统计学意义(P>0.05)。③经Logistic多因素回归分析,EPA和DHA与ACS独立相关。结论ACS患者血清EPA和DHA含量明显降低,其水平与ACS的发生有关;血清EPA和DHA含量可能是预测冠状动脉病变的指标;血清EPA和DHA可能是冠心病的保护性因子。

Objective To investigate the changes of serum omega -3 polyunsaturated fatty acids （ω -3PUFA： ALA, EPA, DHA） content with acute coronary syndrome （ACS）, also to analyze the relationship between the serum content of ω -3PUFA and num- ber of diseased vessel in coronary artery disease （CAD）. Methods One hundred and twenty patients was divided into ACS group and control group. After coronary angiography, ACS was also divided into two groups according to the number of diseased vessel： single - vessel disease group （SVD） and multi- vessel disease group （MVD）. The content of serum ω- 3PUFA was determined by the gas chromatography/mass spectrometry （GC/MS） method. Results Comparing with control group, EPA and DHA content decreased （ P 〈 0.05） in the ACS group. ALA content showed no significant difference between two groups; Comparing with control group, EPA and DHA content decreased （P 〈 0.05 ） in the MVD group and SVD group. No differences of both EPA and DHA content were found be- tween SVD group and MVD group. The ALA content showed no significant difference among those three groups; with multivariate logistic stepwise regression analysis, EPA and DHA independently correlated with ACS. Conclusion EPA and DHA content may be related to the development of ACS. The serum content of EPA and DHA may be used to predict CAD. Serum EPA and DHA may be the protective factor of coronary heart disease.