冠心病患者血清脂蛋白相关磷脂酶A2同型半胱氨酸与冠状动脉病变程度及相关脂蛋白的研究

Serum lipoprotein-associated phospholipase A2 homocysteine and degree of coronary artery disease and related lipoproteins in patients with coronary heart disease

目的回顾性分析血清脂蛋白相关磷脂酶A2(lp-pla2)、同型半胱氨酸(Hcy)及相关脂蛋白之间的相关性,并比较不同血清lp-pla2水平与冠状动脉病变程度相关性。方法收集2018年9月至2019年3月入住山西医科大学第二医院心内科行冠状动脉造影术确诊冠心病的129例患者及同期入住的110名健康体检者作为对照,收集一般资料、血清、相关检查结果,将冠状动脉造影结果诊断为冠心病的患者进一步根据Gensini评分评价冠状动脉病变狭窄程度。用酶联免疫吸附法测定患者血清中lp-pla2的含量,并将冠心病组按4分位数法分为四组。结果相对于健康体检者,lp-pla2、Hcy在冠心病患者中显著升高(P<0.05)。冠心病患者在血清lp-pla2水平不同分组之间Gensini评分差异有统计学意义,且随着Gensini评分增加而升高。多因素Logistic回归分析显示lp-pla2、Hcy是冠心病的危险因素(P<0.05)。结论Hcy是冠心病独立危险因素。冠心病患者lp-pla2水平与冠状动脉病变程度呈正相关,lp-pla2是重度冠状动脉病变的独立危险因素。

Objective To retrospectively investigate the correlation between serum lipoprotein-associated phospholipase A2(lp-pla2),homocysteine(Hcy),and related lipoproteins,and to compare the correlation between different serum lp-pla2 levels and the degree of coronary artery disease.Methods A total of 129 patients diagnosed with coronary heart disease(CHD),who underwent coronary angiography in the Department of Cardiology in the Second Hospital of Shanxi Medical University between September 2018 and March 2019,were included as the subjects in the study.A contemporary cohort of 110 healthy subjects was included as the control group.The general data,and serum and related test results were collected.Coronary artery stenosis in the patients diagnosed with CHD by coronary angiography was further evaluated according to the Gensini score.Enzyme-linked immunosorbent assay was used to determine the serum level of lp-pla2,and the CHD group was divided into four groups according to the quartile method.Results Compared with the healthy subjects,the levels of lp-pla2 and Hcy increased significantly in CHD patients(P<0.05).There was significant difference in Gensini scores between CHD patients with different serum lp-pla2 levels,and the levels increased along with the increasing Gensini scores.Multivariate Logistic regression analysis showed that lp-pla2 and Hcy were risk factors for CHD(P<0.05).Conclusion Hcy is an independent risk factor for CHD.The level of lp-pla2 is positively correlated with the degree of CHD.Lp-pla2 is an independent risk factor for severe CHD.