高血压合并冠心病病人脂蛋白相关磷脂酶A_2、类胰蛋白酶水平变化的相关研究

Correlation of Lipoprotein Associated Phospholipase A_2 and Serum Tryptase in Patients with Hypertension Complicated with Coronary Heart Disease

目的观察脂蛋白相关磷脂酶A_2、(LP-PLA_2)、血清类胰蛋白酶(TPS)在高血压合并冠心病病人的水平变化,探讨其与颈动脉内中膜厚度(IMT)、冠脉病变程度的相关性及临床意义。方法选择临床确诊的伴有高血压的冠心病病人65例,不伴有高血压的冠心病病人55例,单纯高血压病30名,健康体检者30名(对照组)。采用酶联免疫法检测所有病人LP-PLA_2、TPS水平,比较各组间差异,并分析其与颈动脉内中膜厚度、冠脉病变程度的相关性。结果 LP-PLA_2、TPS水平在单纯高血压组、冠心病组水平均高于对照组,且伴有高血压的冠心病组LP-PLA_2、TPS水平高于不伴高血压的冠心病组和单纯高血压病组。LP-PLA_2、TPS水平与IMT存在正相关(偏回归系数分别为5.681、0.323,P<0.05),两者与冠状动脉Gensini评分呈明显正相关(偏回归系数分别为8.191、0.318,P<0.05)。结论 LP-PLA_2、TPS作为炎性因子参与高血压的发生发展过程,随着高血压炎症反应的不断增强,其水平随之升高,且同相关靶器官损害的特异标记有相关性,表明二者可以作为高血压风险程度的预警因子。

Objective To compare the levels of lipoprotein associated phospholipase A2（LP- PLA2） and serum tryptase （TPS） in patients of essential hypertension （EH） complicated with coronary heart disease （CHD） , and explore the clinical correlation between them and intimamedia thickness and coronary artery lesion degree.Methods Sixty- five patients with EH complicated with CHD, 55 patients with CHD, 30 patients with hypertension were participated in the study.Thirty healthy individuals were as controls.The levels of LP PLA2 and TPS were detected by enzyme - linked immunoassay.The correlation of LP - PLA2 and TPS levels with the carotid artery in the film thickness （IMT） and coronary artery lesion degree were analyzed.Results The levels of LP - PLA2 and TPS at the pure hypertension, coronary heart disease group were higher than the control group, and accompanied by hypertension coronary heart disease group LP PLA2, TPS level higher than that of without hypertension coronary heart disease （CHD） and pure hypertension group.LP PLA2, TPS levels were positively correlated with IMT （partial regression coefficient were 5.681 and 0.323, P 〈0.05）, with both coronary artery Gensini score was significantly positive correlation （partial regression coefficient were 8.191 and 0.318, P 〈0.05）. Conclusion As inflammatory factors, LP- PLA2 and TPS involved in pathological progress of hypertension and inflammation.With the levels increasing, and correlated with specific markers with related target organs damage, shows that the degree of risk warning factor can be used as high blood pressure.