冠心病合并糖尿病患者人血浆脂蛋白相关磷脂酶A2的变化及意义

Changes and Significance of Serum Lp-PLA2 in CHD with DM Patient

冠心病和糖尿病在发达国家人群中的发病率逐年上升。冠心病的病理机制是以脂质堆积、纤维化及炎症反应等病理生理变化为特点,其发生是多种因素相互作用,吸烟、高脂血症、糖尿病等因素导致脂类代谢紊乱、内皮细胞损伤、平滑肌细胞迁移增殖和单核细胞源性泡沫细胞形成。人血浆脂蛋白相关磷脂酶A2(Lipoprotein Associated Phospholipase A2,Lp-PLA2)是血小板活化因子乙酰水解酶,它能催化脂蛋白和细胞膜上的甘油磷脂二位酰基脂键水解,从而形成非酯化脂肪酸和溶血磷脂的酶,其产生受炎症介质的调节。近年来研究显示LP-PLA2具有促动脉粥样硬化作用。我们选择233例冠心病患者,研究LP-PLA2水平的变化,分析其在不同临床类型的冠心病患者中的差异,及其与其它指标的关系,从而为研究LP-PLA2在冠心病的临床价值进一步提供依据。

The incidence of coronary heart disease(CHD)and diabetes mellitus(DM)in the developed countries is increasing.The pathogenesis of CHD is characterized by lipid accumulation,fibrosis and inflammatory response and other pathophysiological changes,which are caused by various factors,such as smoking,hyperlipidemia,DM,etc.,that inducing lipid metabolism disorder,endothelial cells impairment,migration and proliferation of smooth muscle cells and formation of foam cells that derived from mononuclear cells.Human lipoprotein associated phos?pholipase A2(Lp-PLA2)is a platelet activating factor acetylhydrolase that catalyzes the hydrolysis of lipoproteins and glycerophospholipid diacylglycide bonds on the cell membrane to form non-esterified fatty acid and lyso?phospholipase,which are regulated by inflammatory mediators.Recent studies have shown that LP-PLA2 can lead to atherosclerosis.A total of 233 patients with CHD were selected in our study to investigate the changes of LP-PLA2 level,and analyze their differences in patients with several clinical types of CHD,as well as their rela?tionship with other indicators,so as to provide a foundation for the clinical value of LP-PLA2 in CHD.