急性冠脉综合征并发2型糖尿病患者血清脂蛋白磷脂酶A2浓度及其与冠状动脉病变程度的相关性

Expression of serum concentration of lipoprotein phospholipase A2 in patients with acute coronary syndrome complicated with type 2 diabetes mellitus and its correlation with severity of coronary artery disease

目的探讨急性冠状动脉综合征(acute coronary syndrome,ACS)并发2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清脂蛋白磷脂酶A2(lipoprotein phospholipase A2,Lp-PLA2)浓度及其与冠状动脉病变程度的相关性。方法选择佛山市第一人民医院禅城医院2017年8月至2018年10月106例ACS患者为研究对象,其中53例无并发糖尿病为对照组,53例并发T2DM为观察组,另选择同期健康体检人群60名为正常组。检测3组受试者血清Lp-PLA2浓度及肱动脉血流介导的血管内皮舒张功能(flow mediated dilation,FMD);计算3组受试者冠状动脉病变Gensini积分;超声检测3组受试者冠状动脉病变程度。结果观察组血清Lp-PLA2浓度、冠状动脉病变Gensini积分明显高于对照组和正常组,差异有统计学意义(P<0.05)。观察组FMD明显低于对照组和正常组,差异有统计学意义(P<0.05)。观察组超声检测参数明显比对照组和正常组差,差异有统计学意义(P<0.05)。与观察组单支或双支冠状动脉病变血管患者比较,冠状动脉病变3支及以上患者血清Lp-PLA2浓度明显上升,差异有统计学意义[(510.64±46.93)ng/mL vs.(443.36±44.58)ng/mL,P<0.05;vs.(510.64±46.93)ng/mL vs.(397.25±38.42)ng/mL,P<0.05]。观察组血清Lp-PLA2浓度与FMD呈负相关,与冠状动脉病变Gensini积分呈正相关。结论ACS并发T2DM患者血清Lp-PLA2浓度增高并与冠状动脉病变程度有关。

Objectives To investigate serum concentration of lipoprotein phospholipase A2(Lp-PLA2)in patients with acute coronary syndrome(A CS) and type 2 diabetes mellitus(T2DM) and its correlation with the severity of coronary artery disease. Methods From August 2017 to October 2018 in Chancheng Hospital, 106 patients with ACS were enrolled in the study. Among them, 53 patients with no accompanying diabetes were included in the control group,53 patients with T2DM were included in observation group,and 60 healthy people who accepted physical examination in the same period in our hospital were selected as normal group. Concentrations of Lp-PLA2 and flow mediated dilation( FMD) in patients of the three groups were measured. Gensini scores of coronary artery of the three groups were caculated. Severity of coronary artery lesion was tested by echocardiogram. Results Serum concentration of Lp-PLA2 and Gensini score of coronary artery lesions in observation group were significantly higher than those in control group and normal group(P <0.05). FMD of observation group was significantly lower than that of control group and normal group(P <0.05). Serum concentration of Lp-PLA2 in patients with 3 or more coronary arteries lesion in observation group was significantly higher than those of patients with single or double coronary arteries lesion[(510.64±46.93) ng/mL vs.(443.36±44.58) ng/mL,P<0.05;vs . (510.64±46.93) ng/mL vs.(397.25±38.42) ng/mL,P<0.05]. Serum concentration of Lp-PLA2 negatively correlated with FMD and positively correlated with Gensini score of coronary artery lesion. Conclusions Serum concentration of Lp- PLA2 in patients with ACS and T2DM increased ,and positively correlated with severity degree of coronary artery lesion.