红细胞膜鞘磷脂和总胆固醇含量在ACS患者临床预测中的应用价值

Clinical application of sphingomyelin and total cholesterol in erythrocyte membrane in patients with acute coronary syndrome

目的：探究红细胞膜鞘磷脂和总胆固醇含量在急性冠脉综合征（ACS）患者临床预测中的应用价值.方法：将243例胸闷或胸痛患者根据其临床症状以及冠脉造影结果分成3组：ACS患者101例,稳定性心绞痛（SAP）患者62例,胸痛不典型且冠状动脉造影正常的患者（对照组）80例;制备所有患者红细胞膜,采用酶学方法检测并比较红细胞膜总胆固醇含量（CEM）、 血清鞘磷脂（SM）含量和红细胞膜鞘磷脂（SEM）含量.结果：ACS组患者CEM、SM和SEM水平均较SAP组和对照组显著升高（P〈0.01）,而SAP组患者CEM、SM和SEM水平与对照组无显著性差异（P〉0.05）;多因素Logistic逐步回归分析表明CEM和SEM都与ACS的发病相关,CEM与ACS的发病危险存在强相关;SEM、CEM与血清中血脂相关指标（TC、TG、LDL-C、HDL-C）以及SM水平无相关性,仅CEM与血清中HDL-C呈负相关.结论：ACS患者SEM及CEM水平的升高与ACS的发病相关,CEM水平是ACS的潜在预测因子.

Objective： To explore the clinical value ofsphingomyelin and total cholesterol in erythrocyte membrane in patients with acute coronary syndromes （ACS） . Methods： 243 patients with chest pain or chest pain were divided into 3 groups according to their clinical symptoms and coronary angiography： 101 patients with ACS, 62 patients with stable angina pectoris （SAP） , 80 patients with atypical chest pain and normal coronary angiography （CEM） （control group） . Serum sphingomyelin （SM） content and erythrocyte membrane sphingomyelin （SEM） content in erythrocyte membrane were measured by enzymatic method and compared. Results： The levels ofCEM, SM and SEM in ACS group were significantly higher than those in SAP group and control group （P 〈0.01） , while the levels of CEM, SM and SEM in SAP group were not significantly different from those in control group （P 〉0.05） . Logistic stepwise regression analysis showed that both CEM and SEM were associated with the onset ofACS; CEM and ACS were significantly associated with the risk of ACS. There was no correlation between serum SEM, CEM and serum TC, TG, LDL-C, only negative correlation existed between CEM and serum HDL-C. Conclusion： The increase of SEM and CEM in patients with ACS is associated with the pathogenesis of ACS; CEM is a potential predictor of ACS.