吸烟对急性冠状动脉综合征患者血清脂蛋白相关磷脂酶A2的影响及意义

Impact and Significance of Smoking on Serum Lipoprotein Associated Phospholipase A2 in Patients With Acute Coronary Syndrome

目的:探讨吸烟急性冠状动脉综合征(ACS)患者血清脂蛋白相关磷脂酶A2(LP-PLA2)的变化,进一步阐明吸烟对该物质的影响及与冠心病的关系。方法:入选170例于2015-01至2015-12因胸痛在我院行冠状动脉造影患者,依据临床表现、冠状动脉造影结果及吸烟史分为:(1)对照组(70例),包括吸烟对照亚组(31例)及非吸烟对照亚组(39例);(2)ACS组(100例),包括吸烟ACS亚组(50例)及非吸烟ACS亚组(50例)。检测血清LP-PLA2、C反应蛋白(CRP)水平。结果:吸烟对照亚组血清LP-PLA2水平高于非吸烟对照亚组(P=0.018),吸烟ACS亚组血清LP-PLA2水平高于非吸烟ACS亚组(P=0.027),ACS组血清LP-PLA2水平显著高于对照组(P=0.000)。血清LP-PLA2水平与CRP呈正相关(r=0.724,P<0.01)。结论:ACS患者血清LP-PLA2、CRP水平较无冠心病者明显升高,提示二者可能直接参与了冠心病的发生、发展,且吸烟者LP-PLA2水平更高,这可能是吸烟者更易罹患冠心病并加重病情进展的原因之一。

Objective： To explore serum levels of lipoprotein associated phospholipase A2（ LP-PLA2） in patients with acute coronary syndrome（ACS） who is smoking, to further clarify the impact of smoking on LP-PLA2 and the relationship with coronary artery disease（CAD）.Methods： A total of 170 patients who received coronary angiography（CAG） because of chest pain in our hospital from 2015-01 to 2015-12 were enrolled. According to CAG results and smoking history, the patients were divided into 2 groups： Control group, n=70 healthy subjects including 2 subgroups as Smoking control subgroup, n=31 and Non-smoking control subgroup, n=39; ACS group, n=100 patients including 2 subgroups as Smoking ACS and Non-smoking ACS subgroups, n=50 in each subgroup. Blood levels of LP-PLA2 and C-reactive protein（CRP） were detected and compared among different groups. Results： Serum levels of LP-PLA2 in Smoking control subgroup was higher than Non-smoking control subgroup, P=0.018; LP-PLA2 level in Smoking ACS subgroup was higher than Non-smoking ACS subgroup, P=0.027; LP-PLA2 level in ACS group was higher than Control group, P=0.000. Serum levels of LP-PLA2 was positively related to CRP（r=0.724, P〈0.01）.Conclusion： Blood levels of LP-PLA2 and CRP were increased in ACS patients suggesting both of them might be involved in CAD occurrence; LP-PLA2 level was even higher in smokers implying this is could be one of the reasons for smokers were more likely to suffer from CAD and aggravate CAD progress.