ω-3多不饱和脂肪酸对不稳定型心绞痛患者脂蛋白相关性磷脂酶A2的影响

Effect of omega-3 polyunsaturated fatty acid on lipoprotein-associated phospholipase A2 in patients with unstable angina

目的探讨ω-3多不饱和脂肪酸对不稳定型心绞痛患者脂蛋白相关性磷脂酶A2的影响。方法选取广东省2家三甲医院60例经皮冠状动脉介入治疗成功的不稳定型心绞痛患者,随机分成对照组和试验组,每组30例。对照组患者术后接受常规的阿司匹林及氯吡格雷治疗,试验组除了接受上述药物治疗外,每日添加服用ω-3 PFUA 1000 mg,记录两组患者一般临床资料,分别在服用ω-3 PFUA前,服用后2周和服用后4周检测患者氧化-LDL和Lp-PLA_2等指标。结果两组患者一般临床资料差异无统计学意义(P>0.05),两组患者服用ω-3 PFUA前Lp-PLA2和氧化LDL水平差异无统计学意义(P>0.05),对照组患者服用ω-3 PFUA 2周及4周后Lp-PLA2和氧化LDL水平与服用前比较差异无统计学意义(P>0.05),试验组服用ω-3 PFUA 2周及4周后患者Lp-PLA2和氧化LDL水平均显著低于服用前及对照组患者(P<0.05)。Lp-PLA2水平与患者BMI呈正相关(r=0.32,P<0.05)。服用ω-3 PFUA(R^2=20.1%,P<0.05)和体质量指数(R^2=10.3%,P<0.05)为Lp-PLA2水平变化的独立预测因素。结论ω-3 PFUA可显著降低不稳定型心绞痛PCI术后患者的Lp-PLA_2水平,这可能是ω-3 PFUA预防心血管疾病发生的潜在机制之一。

Objective To confirm the effect of omega-3 polyunsaturated fatty acid （PFUA） on lipoprotein-associatedphospholipase A2 （Lp-PLA2） in patients with unstable angina. Methods 60 patients with unstable angina after successfulpercutaneous coronary intervention （PCI） were randomly divided to control group and experimental group （n = 30）. Patients inthe control group received aspirin and clopidogrel treatment after PCI, and patients in the experimental group receivedadditional omega-3 PFUA 1000 mg every day. Patients’ clinical data in both groups were collected, and oxy-LDL and Lp-PLA2were detected before and 2 and 4 weeks after omega-3 PFUA treatment. Results There were no significant differences in theclinical data and in Lp-PLA2 and oxy-LDL before omega-3 PFUA treatment between the experimental group and the controlgroup （P〉0.05）. Two and four weeks after omega-3 PFUA treatment, there were no significant differences in Lp-PLA2 and oxy-LDL in the control group when compared to that before omega-3 PFUA treatment （P〉0.05）, but Lp-PLA2 and oxy-LDL in theexperimental group were significantly lower when compared to that before omega-3 PFUA treatment （P〈0.05）. Moreover, Lp-PLA2 were positively correlated with baseline body mass index （BMI, r=0.32, P〈0.05）. The multivariate model showed thattreatment with omega-3 PUFA （R^2=20.1%, P〈0.05） and baseline BMI （R^2=10.3%, P〈0.05） were independent predictors of Lp-PLA2 changes at 4 weeks. Conclusion Omega-3 PFUA could significantly reduce Lp-PLA2 in with unstable anginaundergoing PCI, which might be a potential mechanism for omega-3 PFUA in cardiovascular disease prevention.