血浆脂蛋白相关磷脂酶A_2和同型半胱氨酸水平与心血管功能状态的关系

Relationship of plasma lipoprotein-associated phospholipase A_2 and homocysteine levels with cardiovascular function

目的探讨血浆脂蛋白相关磷脂酶A_2(plasma lipoprotein-associated phospholipase A_2,Lp-PLA_2)、同型半胱氨酸(homocysteine,Hcy)与心血管功能状态的关系,评价健康风险评估(Health Risk Appraisal,HRA)系统的临床应用价值。方法 208例体检者根据HRA系统描述的心血管风险分层信息分为5组,心血管功能正常28例为心血管功能正常组,血压变化64例为血压变化组,血脂水平变化12例为血脂变化组,下肢血管循环功能改变59例为下肢血管循环功能改变组,冠状动脉硬化倾向45例为冠状动脉硬化倾向组。分别采用ELISA法、酶循环法检测各组Lp-PLA_2、Hcy的水平,并进行比较。结果B、C、D、冠状动脉硬化倾向组Lp-PLA_2[(0.80±0.49)、(0.65±0.44)、(0.81±0.53)、(0.80±0.53)μg/L]、Hcy[(14.29±6.97)、(14.59±3.59)、(14.15±5.42)、(16.83±9.12)μmol/L]均高于心血管功能正常组[(0.41±0.25)μg/L、(10.13±2.36)μmol/L],差异有统计学意义(P<0.05)。结论血浆Lp-PLA_2、Hcy水平升高与心血管功能状态相关,HRA系统可用于早期心血管系统功能状态变化的评估。

Objective To investigate the relationship of plasma lipoprotein-associated phospholipase A2 （Lp-PLA2） and homocysteine （Hcy） levels with cardiovascular function and to evaluate the clinical application value of Health Risk Appraisal （HRA） system. Methods A total of 208 individuals receiving physical examination were divided into 28 patients with normal cardiovascular function （normal group）, 64 patients with changed blood pressure （blood change group）, 12 patients with changed blood lipid level （lipid change group）, 59 patients with changed lower limb vascular circulation function （circulation change group） and 45 patients with coronary atherosclerosis tendency （atherosclerosis group） according to the results of Health Risk Appraisal （HRA） system. The levels of Lp-PLA2 and Hcy were detected by ELISA and enzyme circulation method in all groups. Results The level of Lp-PLA2 was （0.80±0.49） μg/L in blood change group, （0. 65±0.44） μg/L in lipid change group, （0.81±0.53）μg/L in circulation change group and （0.80± 0.53） μg/L in atherosclerosis group, and the level of Hcy was （14. 29226.97） μmol/L in blood change group, （14.59± 3.59） μmol/L in lipid change group, （14.15±5.42） μmol/L in circulation change group and （16.83±9.12） μmol/L in atherosclerosis group, significantly higher than those in normal group （（0. 41 ± 0.25） μg/L, （10.13 ± 2.36） μmol/L） （P〈0.05）. Conclusion The increased Lp-PLA2 and Hcy levels are correlated with cardiovascular function. HRA system can be used to evaluate the early changes of cardiovascular function.