冠心病患者血浆Lp-PLA_2水平与冠状动脉病变的临床关系探讨

Association between plasma level of lipoprotein-associated phospholipase A_2 and coronary artery disease in patients with coronary heart disease

目的探讨冠心病患者血浆脂蛋白相关磷脂酶A_2(Lp-PLA_2)水平与冠状动脉病变的临床关系。方法选取146例冠心病患者和100例健康志愿者,分别记为疾病组和健康组。所有受试者均采用酶联免疫法测定血浆Lp-PLA_2水平,并对疾病组患者实施冠状动脉造影检查,根据检查结果对冠状动脉进行Gensini积分。对比疾病组和健康组血浆Lp-PLA_2水平,并对比Gensini积分≤19分、20-39分和≥40分3个亚组血浆Lp-PLA_2水平。结果疾病组患者血浆Lp-PLA_2水平明显高于健康组(P<0.05),Gensini积分≤19分、20-39分和≥40分3个亚组血浆Lp-PLA_2水平对比差异显著(P<0.05),且Gensini积分≥40分者血浆Lp-PLA_2水平均远高于Gensini积分≤19分、20-39分者(P<0.05),且Gensini积分20-39分者血浆LP-PLA_2水平远高于Gensini积分≤19分者(P<0.05)。结论冠心病患者血浆Lp-PLA_2水平明显高于正常人群,且冠状动脉狭窄越严重,该因子水平越高,可用以评估冠状动脉病变程度。

Objective To investigate the association between plasma level of lipoprotein-associated phospholipase A2（Lp-PLA2） and coronary artery disease in patients with coronary heart disease. Methods A total of146 patients with coronary heart disease were enrolled as disease group, and 100 healthy volunteers were enrolled as healthy group. ELISA was used to measure the plasma level of Lp-PLA2 in all patients; coronary angiography was performed for all patients in the disease group, and the Gensini score of the coronary artery was determined based on the results of coronary angiography. The plasma level of Lp-PLA2 was compared between the disease group and the healthy group, as well as between the Gensini score ≤19, 20-39, and ≥40 subgroups. Results The disease group had a significantly higher plasma level of Lp-PLA2 than the healthy group（P〈0.05）. There was a significant difference in the plasma level of Lp-PLA2 between the Gensini score ≤19, 20-39, and ≥40 subgroups（P〈0.05）; the Gensini score ≥40 subgroup had a significantly higher level than the other two subgroups（P〈0.05）, and the Gensini score 20-39 subgroup had a significantly higher level than the Gensini score ≤19 subgroup（P 0.05）. Conclusion Patients with coronary heart disease have a significantly higher plasma level of Lp-PLA2 than the healthy population, and the plasma level of Lp-PLA2 increases with the increase in the severity of coronary artery stenosis. Therefore, it can be used to evaluate the degree of coronary artery disease.