急性冠脉综合征患者血浆神经鞘磷脂变化的临床意义

The clinical significance of the change of the content of sphingomyelin in plasma in patients with acute coronary syndrome

目的观察血浆鞘磷脂(sphingomyelin,SM)含量在汉族人群急性冠脉综合征(acute coronary syndrome,ACS)患者中的变化,了解其对ACS患者斑块不稳定性的预测价值。方法选择2009年3月—2013年2月安徽铜陵市人民医院心血管内科汉族人群中稳定性心绞痛(stable angina pectoris,SAP)患者61例,ACS患者(包括不稳定性心绞痛、ST段抬高型心梗和非ST段抬高型心梗)195例,正常对照组55例,采用酶学的方法分别测定其血浆SM含量。结果①ACS组血浆SM水平明显高于SAP组及对照组(P<0.01,P<0.01),而SAP组及对照组SM水平差异无统计学意义(P=0.839)。②ACS的相关危险性因素经多因素logistic回归分析得出SM是ACS的独立危险因素。结论本研究结果显示,汉族人群SM水平与ACS具有相关性,提示SM可能是汉族人群中ACS患者斑块不稳定性的一个潜在标记物,可能具有一定的临床预测价值。

Objective Observing the change of the content of sphingomyelin in plasma in patients with acute coronary syndrome of Han population;exploring their predictive value about plaque instability. Methods Choosing 61 patients with stable angina pectoris, 195 patients with acute coronary syndrome（ including unstable angina pectoris, ST segment el- evation myocardial infarction and non-ST-segment elevation myocardial infarction）, 55 cases as normal control group in the patients of Han population of Department of Cardiology of Tongling People＇ s Hospital of Anhui from March in 2009 to February in 2013, and the content of plasma sphingomyelin were determined using the enzymatic assay. Results The SM content of ACS group was significantly higher than that of SAP group and control group （P 〈 0.01, P 〈 0.01 ） , while the SAP group and control group had no significant difference in the content of SM （ P = 0.839 ）. The risk factors related to ACS analyzed by multivariate logistic regression showed that SM was independent risk factors for ACS. Conclusion The results showed that there was a significant correlation between SM content of the Han population and ACS, suggesting that SM content of Han population may be a potential marker of instability atherosclerotic plaque and may be have some clini- cal predictive value.