冠心病患者血清脂蛋白相关磷脂酶A2与氧化低密度脂蛋白水平

The levels of serum lipoprotein associated phospholipase A2 and oxidized LDL in patients with coronary artery disease

目的分析冠心病(CAD)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、氧化低密度脂蛋白(ox-LDL)水平。方法分别检测100例急性冠脉综合征(ACS)、75例稳定性心绞痛(SAP)患者和50例健康人对照者的血清Lp-PLA2、ox-LDL水平及CAD病变程度,分析其相关关系。结果与健康人对照组相比,CAD患者血清Lp-PLA2、ox-LDL水平均显著升高(P<0.01);与SAP组相比,ACS组血清Lp-PLA2、ox-LDL、肌钙蛋白I(TnI)水平及Gensini积分均显著升高(P<0.01)。相关性分析显示,CAD患者Gensini积分分别与血清Lp-PLA2(r=0.426,P<0.01)、ox-LDL(r=0.331,P<0.01)水平呈正相关,Lp-PLA2与ox-LDL之间亦显著正相关(r=0.238,P<0.01)。多元回归分析显示,CAD患者血清Lp-PLA2(β=0.366,P<0.01)和ox-LDL(β=0.253,P<0.01)水平共同决定了22.7%的Gensini积分变化;Gensini积分是血清Lp-PLA2的唯一显著的独立预测因子(β=0.420,P<0.01);LDL胆固醇(LDL-C)(β=0.411,P<0.01)、Gensini积分(β=0.285,P<0.01)共同决定了25.9%的ox-LDL变化。结论 CAD患者血清Lp-PLA2、ox-LDL水平升高,且与动脉粥样硬化(As)病变程度密切相关。

Objective To investigate the levels of serum lipoprotein associated phospholipase A2 （Lp-PLA2 ） and oxidized low-density lipoprotein （ox-LDL） in patients with coronary artery disease （CAD）. Methods The level of serum Lp-PLA2 and ox-LDL were meas- ured in 100 patients with acute coronary syndromes （ACS） , 75 with stable angina pectoris （SAP） and 50 healthy controls, and the Gensini score of each CAD patient was obtained. Results Compared to controls, both the levels of Lp-PLA2 and ox-LDL in patients with CAD were significantly increased （P 〈 0.01 ）. Furthermore, the levels of Lp-PLA2, ox-LDL, TnI and the Gensini score in pa- tients with ACS were higher than those in patients with SAP （ P 〈 0.01 ）. Lp-PLA2 （ r = 0.426, P 〈 0.01 ） and ox-LDL （ r = 0.331, P 〈 0.01 ） levels were positively related with Gensini score, and Lp-PLA2 levels were also correlated with ox-LDL （ r = 0. 238, P 〈 0.01 ）. The multiple linear regression analysis showed that Lp-PLA2 （β= 0. 366, P 〈 0.01 ） and ox-LDL （β = 0. 253, P 〈 0.01 ） jointly determined 22.7% of the variation of Gensini score in patients with CAD, and LDL-C （β = 0. 411, P 〈 0.01 ） and Gensini score （β = 0. 285, P 〈 0.01 ） jointly determined 25.9% of the variation of ox-LDL levels. Gensini score was the only significant inde- pendent predictor of Lp-PLA2 levels （β = 0.420, P 〈 0.01 ） in the patients with CAD. Conclusion Both the levels of serum Lp-PLA2 and ox-LDL were increased and associated with the severity degree in patients with CAD.