血浆脂蛋白相关磷脂酶A2活性与冠脉病变程度和冠心病的关系分析

Analysis on the correlation of the activity of plasma lipoprotein associated phospholipids A2 with the severity of coronary artery lesions and coronary heart disease

目的探讨临床中血浆脂蛋白相关磷脂酶A2（Lp～PLA2）活性与冠脉病变程度和冠心病的相关性。方法选取高州市人民医院心血管内科2012年1月～2013年6月60例冠心病患者为研究组，同期60例行冠状动脉造影术（CAG）未见有冠状动脉狭窄的患者为对照组，并将研究组中冠心病的临床类型和冠脉病变支数以及Gensini积分分为不同亚组。采取ELISA法测定Lp—PLA2水平。结果研究组中稳定型心绞痛、不稳定型心绞痛、心肌梗死患者的Lp—PLA2活性分别为（26．32±0．77）、（29．14±0．42）、（32．21±0．78）μmol／（min·mL），均明显高于对照组[（21．32±1．56）μmol／（min·mL）]，差异有统计学意义（P〈0．05）；且稳定型心绞痛、不稳定型心绞痛、心肌梗死患者的Lp—PLA2活性比较差异也有统计学意义（P〈0．05）。研究组中单支病变和双支病变以及三支病变的Lp—PLA2活性分别为（26．13±1．45）、（28．78±1．36）、（31．67±1．47）μmol／（min·mL），均明显高于对照组[（21．32±1．56）μmol／（min·mL）]，差异有统计学意义（p〈0．05）；且单支病变和双支病变以及三支病变患者的Lp—PLA2活性比较差异也有统计学意义（P〈0．05）。研究组中0～〈20分和20～〈40分以及≥40分的Lp—PLA2活性分别为（26．07±1．32）、（28．71±1．27）、（31．78±1．41）μmol／（min·mL），均明显高于对照组[（21．32±1．56）μmol／（min·mL）]，差异有统计学意义（P〈0．05）；且0～〈20分和20～〈40分以及≥40分患者的Lp—PLA2活性比较差异也有统计学意义（P〈0．05）。结论Lp—PLA2与冠心病的发生具有一定的联系，对该病的预测具有一定的意义。同时，该指标活性能够有效地反映出冠状动脉硬化的病变程度。

Objective To explore the correlation of the activity of plasma lipoprotein associated phospholipids A2 （Lp- PLA2） with the severity of coronary artery lesions and coronary heart disease in clinic. Methods 60 eases of patients with coronary heart disease in Department of Cardiovascular Medicine in the People＇s Hospital of Gaozhou from January 2012 to June 2013 were chosen as study group, in the same period, 60 cases of patients without coronary artery stenosis detected by CAG were as control group. The clinical types of coronary heart disease, the number of coronary artery lesions and Gensini scores in the study group were divided into different subgroups. The level of Lp-PLA2 was detected by ELISA method. Results The activities of Lp-PLA2 of stable angina, unstable angina, myocardial infarction in study group were （26.32±0.77）, （29.14±0.42）, （32.21±0.78） μmol/（min· mL）, which were significantly higher than that in the control group [（21.32±1.56） μmol/（min·mL）], the differences were statistically significant （P 〈 0.05）; and the Lp- PLA2 activities of stable angina, unstable angina, myocardial infarction also had significant differences （P 〈 0.05）. The activities of Lp-PLA2 of single vessel lesion and double branch lesions and three lesions in the study group were （26.13±1.45）, （28.78±1.36）, （31.67±1.47） μmol/（min·mL）, which were significantly higher than that in the control group [（21.32±1.56） μmol/（min·mL）], the differences were statistically significant （P 〈 0.05）; and the Lp-PLA2 activities of the single branch lesion and double branch lesions and three lesions also had significant differences （P 〈 0.05）. The activities of Lo-PLA2 of 0-〈20 scores, 20-〈40 scores and ≥40 scores in the study group were （26.07±1.32）, （28.71±1.27）, （31.78±1.41） μmol/（min·mL）, which were significantly higher than that in the control group [（21.32±1.56） μmol/（min·mL）], the differences were statistically significant （P 〈 0.05）, and the Lp-PLA2 activities of 0-〈20 scores, 20-〈40 scores and ≥40 scores also had statistically significant differences （P 〈 0.05）. Conclusion Lp-PLA2 has a connection with the occurence of coronary heart disease, which has a certain significance for the prediction of the disease. At the same time, the activity of this index can effectively reflect the severity of coronary atherosclerosis.