急性冠状动脉综合征患者血浆五聚素3与脂蛋白相关磷脂酶A2水平及临床意义

Plamsa level of pentraxin 3 and lipoprotein-associated phospholipase A2 in patients with acute coronary syndrome and its clinical significance

目的探讨血浆五聚素3(PTX3)与脂蛋白相关磷脂酶A2(LP-PLA2)水平对急性冠状动脉综合征早期的预测价值以及冠状动脉支架置入术(PCI)前后其血浆水平的变化。方法选择冠状动脉造影检查明确无冠状动脉狭窄患者(对照组)20例,急性冠状动脉综合征(ACS)患者20例,稳定型心绞痛(SAP)患者20例。所有研究对象入院后即刻采集血液标本集中测定PTX3及LP-PLA2含量。ACS患者于PCI术后1个月复测上述指标血浆水平值。结果 (1)ACS组血浆PTX3水平[(3.58±0.43)ng/ml]显著高于SAP组[(1.95±0.24)ng/ml]及对照组[(1.54±0.21)ng/ml](P<0.001),同样ACS组LP-PLA2水平[(604.00±145.51)ng/ml]显著高于SAP组[(403.75±44.38)ng/ml]及对照组[(235.62±83.66)ng/ml](P<0.001);(2)PCI术后1个月患者血浆PTX3水平[(2.15±0.14)ng/ml]和LP-PLA2水平[(314.00±20.35)ng/ml]较术前显著降低(P<0.001)。结论血浆PTX3及LP-PLA2水平可作为ACS早期生物标记物;血浆PTX3及LP-PLA2水平可以反映冠状动脉病变斑块的稳定性。

Objective To explore the pentraxin 3（PTX3） and lipoprotein-associated phospholipase A2（LP-PLA2） level for early prediction value of acute coronary syndrome, and their changes in plasma before and after percutaneous coronary intervention（PCI）. Methods Proved with coronary artery angiography, 20 controls without coronary artery stenosis, 20 patients with acute coronary syndrome（ACS） and 20 patients with stable angina pectoris（SAP） were enrolled in for comparison. Blood samples were collected for assessment of plasma LP-PLA2 and PTX3 expression at hospitalization from all subjects and 1 month after PCI in patients with ACS. Results Significantly higher plasma level of PTX3 [（3.58±0.43）ng/ml] was observed in ACS group than those in SAP group [（1.95±0.24）ng/ml] and control group [（1.54±0.21）ng/ml]（P〈0.001）, as well as LP-PLA2 [（604.00±145.51）ng/ml] were observed in ACS group than those in SAP group [（403.75±44.38）ng/ml] and control group [（235.62±83.66）ng/ml]（P〈0.001）. Furthermore, comparing with baseline levels, significant reduction of plasma level of PTX3 [（2.15±0.14）ng/ml] and LP-PLA2 [（314.00±20.35）ng/ml] was observed in 1 month after PCI in ACS group（P〈0.001）. Conclusion The plasma level of PTX3 and LP-PLA2 can be used as early biomarkers of ACS. Plasma level of PTX3 and LP-PLA2 can reflect the stability of the lesions plaques in the coronary artery.