多聚赖氨酸结合脂蛋白(a)检测方法的初步确立及其对急性心肌梗死的实验诊断价值

Tentatively Establishing the Method of Detecting Lipoprotein(a) of Combining to Polyphosphate Lysine and the Laboratory Diagnostic Value of the Method in Acute Myocardial Infarction

目的初步建立检测功能性脂蛋白(a)质量的检测方法,分析该方法的精密度、准确度和干扰因素。方法利用该方法测定急性心肌梗死和不稳定型心绞痛患者冠状动脉造影确诊时即支架术术前和术后4 h、8 h、12h、24 h、48 h、72 h、4～9天、10～12天各个时间点与多聚赖氨酸结合的脂蛋白(a)的质量,并用直接酶联免疫吸附试验和免疫比浊试验检测急性心肌梗死和不稳定型心绞痛患者的脂蛋白(a)的总质量,比较检测二者的诊断价值,并将该方法与传统心肌标志物肌酸激酶同工酶进行比较,评价其诊断和监测心血管疾病的价值。结果酶联免疫吸附试验和免疫比浊试验检测的心血管患者的脂蛋白(a)质量变化不大(P>0.05);与多聚赖氨酸结合的脂蛋白(a)的吸光度值明显增高(P<0.05);该方法的精密度和准确度都很高(>90%),诊断价值优于肌酸激酶同工酶。结论传统检测脂蛋白(a)的方法不能解释其与心血管疾病的关系;自建的检测与多聚赖氨酸结合的脂蛋白(a)的方法与心血管疾病状态一致,该方法的可行性高,并且也能进一步研究功能性脂蛋白(a)的生理病理功能。

Aim To establish the method of detecting functional lipoprotein （a） [ Lp （a） ] , and evaluate it, then compare its effect with creatine kinase isozyme at the diagnosis and detection of the acute myocardial infarction. Methods The level of lipoprotein （ a ） and lipoprotein （a） combining to polyphosphate lysine at preoperative and postoperative 4 h, 8 h, 12 h, 24 h, 48 h and 72 h, 4 -9 days and 10 - 12 days points were detected respectively in acute myocardial infarction and unstable angina patients by enzyme-linked immunosorbent assay and immune turbidimetrie assay. Results The change of lipoprotein （a） level was lower（ P 〉 0. 05 ） ; However, the change of lipoprotein （a） combining to polyphosphate lysine was larger in acute myocardial infarction （ P 〈 0. 05 ） ; The precision and accuracy of the method is better （ 〉 90% ） ; The diagnostic value was more superior than creatine kinase isozyme. Conclusion The level of lipoprorein （a） detected by traditional methods fail to associate with the cardiovascular disease ; The method that detecting the level of lipoprotein（a） combining to polyphosphate lysine can diagnose and monitor cardiovascular disease, and the method can be used to research the pathological mechanism of lipoprotein（a）.