急性心肌梗死后血小板活化因子及脂蛋白相关磷脂酶A2的表达

The expression of platelet activating factor and lipoprotein-associated phospholipase A2 after acute myocardial infarction

目的探讨急性心肌梗死后不同时间血小板活化因子(PAF)和脂蛋白相关磷脂酶A2(Lp-PLA2)的表达。方法选取2015年6月至2016年8月浙江省人民医院就诊的急性ST段抬高心肌梗死患者(STEMI组)50例,检测其入院即刻、24h、72h、1周及2周时的PAF、Lp-PLA2水平以及血常规,超敏C反应蛋白和生化指标,并与30例稳定性冠心病患者(稳定性冠心病)及30例健康体检者(对照组)比较。结果 STEMI组入院即刻白细胞、中性粒细胞百分比、血糖均显著高于稳定性冠心病组和对照组,差异均有统计学意义(P<0.05)。稳定性冠心病组患者LDL-C水平低于对照组,差异有统计学意义(P<0.05)。PAF水平在急性心肌梗死后入院即刻最高,显著高于其他时段测值及稳定性冠心病组和对照组测值(均P<0.05)。STEMI组各个时间点Lp-PLA2水平与稳定性冠心病组、对照组比较,差异均无统计学意义(均P>0.05)。hs-CRP在STEMI组入院72h时最高,与STEMI组入院即刻、24h、1周、2周、稳定性冠心病组、对照组比较,差异均有统计学意义(均P<0.05)。STEMI患者入院即刻中性粒细胞百分比与PAF水平存在相关性(P<0.05)。结论急性心肌梗死后PAF水平升高,以早期最为明显,Lp-PLA2无明显变化。

Objective To explore the expression of platelet activating factor(PAF)and lipoprotein-associatedphospholipase A2(Lp-PLA2)at different time points after acute ST elevation myocardial infarction(STEMI).Methods50cases of patients with STEMI were enrolled.Levels of PAF,Lp-PLA2as well as hsCRP,blood biochemical parameters androutine blood examination were measured at admission and24hours,72hours,one week and two weeks after AMI andcompared to that of patients with stable coronary heart disease(CAD group)(n=30)and healthy people(control group)(n=30).Results The counts of leucocyte,the percent of neutral granulocyte and fast blood glucose at admission in STEMI groupwere significantly higher than that in CAD group and control group(all P<0.05).LDL-C was significantly lower in CAD groupthan in control group(P<0.05).PAF levels at admission was significantly higher than that of other time points in STEMI group(all P<0.05)and that of CAD group and control group(all P<0.05).Lp-PLA2levels were not significantly different amongdifferent time points in STEMI group and between different groups.hsCRP was significantly higher at72hour than other timepoints in STEMI group and than other group(all P<0.05).The percentage of neutral granulocyte was correlated with PAF atadmission in STEMI group.Conclusion PAF level increases in STEMI patients with the highest at admission,whileLp-PLA2does not change.