心肌梗死患者血清低密度脂蛋白亚组分及与临床生物化学指标的相关性

The correlation between serum low density lipoprotein subfractions and clinical biochemical indicators in patients with myocardial infarction

目的探讨心肌梗死患者血清低密度脂蛋白(LDL)亚组分的分布特征并分析其与急性心肌梗死、陈旧性心肌梗死患者血清临床生物化学指标的相关性。方法采集并筛选14例急性心肌梗死患者、24例陈旧性心肌梗死患者和19例健康体检者的新鲜血清,采用Lipoprint脂蛋白亚类分析系统检测血清LDL亚组分组成和含量。结果急性心肌梗死和陈旧性心肌梗死患者血清LDL平均粒径、I-LDL含量和百分比显著降低(P<0.01),小LDL(S-LDL)含量和百分比显著升高(P<0.01);从急性心肌梗死到陈旧性心肌梗死血清S-LDL尤其是LDL5C、LDL6C、LDL7C与血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)、载脂蛋白B(Apo B)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(c Tn T)的相关性发生了显著性变化。结论 LDL粒径的降低,S-LDL含量与百分比的升高,较LDLC浓度的单独升高对心肌梗死患者的精准检测和诊断有非常重要的指导意义,血清LDL5C、LDL6C、LDL7C与临床生物化学指标相关性的检测对临床诊断心肌梗死以及鉴别诊断急性心肌梗死、陈旧性心肌梗死有极大的辅助诊断价值。

Aim To investigate the distribution characteristics of plasma low density lipoprotein（LDL） subfractions in patients with myocardial infarction and to analyze the correlation between the subfractions and serum clinical biochemical indicators in patients with acute myocardial infarction（AMI） and old myocardial infarction（OMI）. Methods The fresh serum of 14 patients with acute myocardial infarction（AMI）,24 patients with old myocardial infarction（OMI）and 19 healthy subjects at the Second Affiliated Hospital of Dalian Medical University from June to December in 2015 were collected and screened. Plasma LDL subfractions composition and content were determined by Lipoprint subclass analysis system. Results Serum LDL average particle diameter,the content and percentage of I-LDL were significantly decreased（P〈0.01）,and the content and percentage of S-LDL were significantly increased in acute myocardial infarction and old myocardial infarction（P〈0.01）. From acute myocardial infarction to old myocardial infarction,serum S-LDL,especially correlation of LDL5 C,LDL6 C,LDL7 Cand serum TC,LDLC,Apo B,CK-MB,c Tn T had undergone significant changes. Conclusion Compared with LDLC concentration increase,the decrease of LDL particle size and the increase of S-LDL content and percentage were very important for the accurate detection and diagnosis of patients with clinical myocardial infarction. The correlation between serum LDL5 C,LDL6 C,LDL7 Cand clinical biochemical indicators have great diagnostic value for the diagnosis of acute myocardial infarction and the differential diagnosis of acute myocardial infarction.