红细胞膜总胆固醇与人血浆脂蛋白磷脂酶A2与冠心病的关系

Correlation of erythrocyte membranes, lipoprotein-associated phospholipase A2 and coronary heart disease

目的探讨红细胞膜总胆固醇(erythrocyte membranes,CEM)和人血浆脂蛋白磷脂酶A2(lipoproteinassociated phospholipase A2,Lp-PLA2)与急性冠脉综合征(acute coronary syndrome,ACS)之间的相关性。方法入选ACS组患者72例、慢性稳定型冠状动脉粥样硬化性心脏病(冠心病)组43例、非冠心病(对照组)患者20例。分别测定入选患者的血浆低密度脂蛋白-胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白-胆固醇(high-density lipoprotein cholesterol,HDL-C)、Lp-PLA2浓度及CEM浓度,对比分析3组间相关指标的差异,并比较CEM浓度与传统冠心病预测指标(LDL-C、HDL-C、Lp-PLA2)对ACS的预测价值的优劣。结果 3组血浆LDL-C、HDL-C浓度比较,差异无统计学意义(P>0.05)。ACS组CEM浓度较对照组、冠心病组均有明显升高,差异有统计学意义(P均=0.000);冠心病组CEM浓度与对照组比较,差异无统计学意义(P=0.159)。ACS组血浆Lp-PLA2浓度较对照组、冠心病组均有明显升高,差异有统计学意义(P均=0.000);冠心病组血浆Lp-PLA2浓度比对照组高,差异有统计学意义(P=0.011)。ACS组血浆Lp-PLA2浓度与CEM浓度呈正相关(r=0.492、P=0.000)。Lp-PLA2与ACS的相关系数为r=0.720(P=0.000)、CEM与ACS的相关系数为r=0.874(P=0.000)。结论CEM与Lp-PLA2对ACS的预测优于传统的LDL-C、HDL-C,且CEM的预测则更加明确的指向ACS。

Objectives To explore the correlation between erythrocyte membranes（CEM） and lipoprotein-associated phospholipase A2（Lp-PLA2） in patients with acute coronary syndrome（ACS）. Methods A total of 72 individuals with ACS, 43 individuals with chronic stable coronary artery diseases（SCAD） and 20 controls were included in this study. Plasma concentrations of low-density lipoprotein cholesterol（LDL-C）, high-density lipoprotein cholesterol（HDL-C）, Lp-PLA2 and contents of CEM of all the patients were measured. We analyzed the differences among the three groups and the correlation between Lp-PLA2 and CEM in ACS group. Results There were no significant differences among the three groups in plasma concentrations of LDL-C and HDL-C（P〉0.05）. CEM content of ACS group was significantly higher than those of SCAD group and control group（P =0.000）. However, there was no significant difference in CEM content between SCAD group and control group（P =0.159）. Plasma concentration of LpPLA2 of ACS group also markedly elevated than those of SCAD group and control group（P =0.000）; plasma concentration of Lp-PLA2 of SCAD group was significantly higher than that of control group（P =0.011）. Plasma concentration of Lp-PLA2 and CEM content were positive correlated in ACS group（r=0.492, P=0.000）. Correlation（r=0.720） between Lp-PLA2 mass and ACS was relatively lower than that（r=0.874） between CEM and ACS（both P=0.000）. Conclusions CEM and Lp-PLA2 have stronger predictive value than LDL-C and HDL-C in ACS prediction,and CEM is more specific to predict the occurrence of ACS.