脂蛋白相关磷脂酶A2和同型半胱氨酸水平与动脉粥样硬化性心脑血管疾病关系的研究

Research on the relationships of Lp-PLA2 and Hcy levels with atherosclerotic cardio-cerebrovascular disease

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、同型半胱氨酸(Hcy)与动脉粥样硬化性心脑血管疾病的关系。方法将198例动脉粥样硬化性心脑血管疾病患者按有无其他危险因素分为合并其它危险因素的动脉粥样硬化性心脑血管疾病组(简称合并危险因素疾病组)和无其他危险因素的动脉粥样硬化性心脑血管疾病组(简称无危险因素疾病组)。另选取58名健康体检者作为正常对照组。采用双抗体夹心酶联免疫法(ELISA)测定3组血浆Lp-PLA2浓度,采用酶循环法测定Hcy浓度。结果与正常对照组相比,无危险因素疾病组和合并危险因素疾病组Lp-PLA2、Hcy浓度均明显升高(q=44.236、P=0.000,q=11.403、P=0.000;q=50.025、P=0.000,q=15.777、P=0.000);合并危险因素疾病组与无危险因素疾病组Lp-PLA2、Hcy浓度差异无统计学意义(q=2.299,P=0.083;q=2.586,P=0.069)。相关分析显示,在无危险因素疾病组和合并危险因素疾病组中,Lp-PLA2和Hcy均无相关性(r=0.069,P=0.375;r=0.053,P=0.566)。均衡其它危险因素,Lp-PLA2、Hcy浓度与冠心病独立相关(OR=1.917,P=0.005;OR=1.883,P=0.013)。无危险因素疾病组和合并危险因素疾病组Lp-PLA2、Hcy联合检测的阳性率均高于单项检测(χ2=8.124,P=0.004;χ2=3.933,P=0.045)。结论血浆Lp-PLA2、Hcy可作为动脉粥样硬化性心脑血管疾病的风险评估指标,二者联合检测对动脉粥样硬化性心脑血管疾病有一定的预测价值。

Objective To investigate the relationships of plasma lipoprotein-associated phospholipase A2(LpPLA2) and homocysteine(Hcy) with atherosclerotic cardio-cerebrovascular disease. Methods A total of 198 patients with atherosclerotic cardio-cerebrovascular disease were classified into the group with traditional risk factors and the group without traditional risk factors. A total of 58 healthy subjects were enrolled as healthy control group. The plasma concentration of Lp-PLA2 was detected by double-antibody sandwich enzyme-linked immunosorbent assay(ELISA),and Hcy level was detected by enzymatic cycling method. Results Compared with healthy control group,Lp-PLA2 and Hcy levels increased significantly in both groups with and without traditional risk factors(q = 44. 236,P = 0. 000; q =11. 403,P = 0. 000; q = 50. 025,P = 0. 000; q = 15. 777,P = 0. 000). No statistical significance was found between groups with and without traditional risk factors for Lp-PLA2 and Hcy levels(q = 2. 299,P = 0. 083; q = 2. 586,P =0. 069). Lp-PLA2 and Hcy levels in groups with and without traditional risk factors had no correlation(r = 0. 069,P =0. 375; r = 0. 053,P = 0. 566). Balanced other risk factors,Lp-PLA2 and Hcy levels were independently correlated with coronary heart disease(OR = 1. 917,P = 0. 005; OR = 1. 883,P = 0. 013). Higher positive rate can be got by LpPLA2 and Hcy combined detection than the individual detections in both groups with and without traditional risk factors(χ2= 8. 124,P = 0. 004; χ2= 3. 933,P = 0. 045). Conclusions Plasma Lp-PLA2 and Hcy levels can be used in risk assessment of atherosclerotic disease,and the combined detection has some predictive significance for atherosclerotic cardio-cerebrovascular disease.