血浆脂蛋白相关磷脂酶A2浓度与不同类型冠心病相关性研究

Relationship between plasma lipoprotein-associated phospholipase A2 and different types of coronary heart disease

目的:通过比较不同类型冠心病(CHD)患者血浆中脂蛋白相关磷脂酶A2(Lp-PLA2)水平,探讨Lp-PLA2与不同类型CHD的相关性。方法:选取2016年2月至2019年1月,在河北北方学院附属第一医院门诊就诊得149例健康受试者和360例经心内科确诊的CHD患者进行血样分析。检测受试者血浆Lp-PLA2的浓度并测定TC、HDL-C、LDL-C、TG、Apo-A1、Apo-B、Lp(a)及hs-CRP的水平。分析不同患者血浆Lp-PLA2浓度在冠心病亚组及与多项实验室指标的相关性。结果:冠心病各亚组血浆Lp-PLA2浓度均明显高于对照组(P<0.05);不稳定型心绞痛(UAP)组和急性心肌梗死(AMI)组的LpPLA2浓度显著高于稳定型心绞痛(SAP)组,P<0.05,AMI组血浆LP-PLA2浓度显著高于UAP组(P<0.05);Lp-PLA2的浓度与hs-CRP正相关(r=0.495,P<0.05),与TC、TG、Apo-A1,Apo-B、HDL-C、LDLC、Lp(a)无明显相关;ROC曲线分析,Lp-PLA2对ACS的特异性高于hs-CRP。结论:Lp-PLA2与CHD及其临床类型的发生、发展密切相关,动脉粥样硬化的炎症反应可能是Lp-PLA2与hs-CRP协同作用的结果,且Lp-PLA2对ACS诊断的特异性高于hs-CRP,因此,Lp-PLA2对动脉粥样硬化(AS)具有重要的临床意义,可能成为冠心病诊断的潜在靶点。

Objective:To investigate the correlation between plasma lipoprotein-associated phospholipase A2(Lp-PLA2)and different types of coronary heart disease(CHD)by comparing the plasma levels of Lp-PLA2 in patients with different types of coronary heart disease.Methods:From February 2016 to January2019,blood samples from 149 healthy subjects and 360 patients with CHD diagnosed by cardiology were analyzed at the outpatient department of the Hebei North University.Plasma levels of TC,HDL-C,LDL-C,TG,Apo-A1,Apo-B,LP A and hs-CRP were measured.To analyze the relationship between plasma Lp-PLA2 concentration in coronary heart disease subgroups and various laboratory parameters Result:After adjusting for age and gender the plasma Lp-PLA2 concentrations in all CHD subgroups were significantly higher than those in the control group(P<0.05).The concentration Lp-PLA2 in the unstable angina pectoris(UAP)group and the acute myocardial infarction(AMI)group was significantly higher than that in the stable angina pectoris(SAP)group(P<0.05),and the concentration of Lp-PLA2 in the AMI group was significantly higher than that in the UAP group(P<0.05).The concentration of Lp-PLA2 increased with the increase of atherosclerotic plaque instability(severity)in CHD group,which was statistically significant.The concentration of Lp-PLA2 in the analysis only showed a positive correlation(r=0.495,P<0.05)in the hs-CRP group,There was no significant difference between LP-PLA2 and TC,TG,Apo-A1,Apo-B,HDL-C,LDL-C,Lp-a.In ACS,the specificity of LP-PLA2 was higher than hs-CRP by ROC curve analysis.Conclusions:Lp-PLA2 is closely related to the occurrence and development of CHD and its clinical types.The inflammatory reaction of arteriosclerosis may be the result of the synergistic effect of Lp-PLA2 and hs-CRP,and the specificity of Lp-PLA2 in the diagnosis of ACS is higher than hs-CRP LP-PLA2 has important clinical significance for AS events and may become a potential target for diagnosis of coronary heart disease.