非阻塞型冠心病患者脂蛋白磷脂酶A2的变化

Changes of Plasma Levels of Lipoprotein-associated Phospholipase A2 in Patients with Non-obstructive Coronary Artery Disease

目的:分析非阻塞型冠心病患者血浆脂蛋白磷脂酶A2(Lp-PLA2)水平变化的临床意义。方法:选取2018年6月—2019年6月于南平市第一医院心血管内科住院的41例非阻塞型冠心病患者为观察组,39例健康人为对照组。采用双抗体夹心免疫层析法检测血浆Lp-PLA2。同时采用酶法及酶清除法测定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)。超敏C反应蛋白(hs-CRP)采用免疫比浊法进行检测。结果:与对照组相比,观察组血浆Lp-PLA2、LDL-C、hs-CRP均明显升高(P<0.05);观察组血浆Lp-PLA2与血浆LDL-C、hs-CRP分别呈正相关(r=0.314,P<0.05;r=0.479,P<0.05);采用Logistic回归分析显示:中和传统危险因素,血浆Lp-PLA2仍是非阻塞型冠心病发生的独立危险因素(OR=1.022,95%CI:1.005~1.039,P<0.05)。结论:本研究提示血浆Lp-PLA2是非阻塞型冠心病患者独立的一项危险因素,炎症反应可能参与非阻塞型冠心病的发生发展。

Objective:To investigate the changes of plasma lipoprotein-associated phospholipase A2(Lp-PLA2)concentration and to analyze its significance in patients with non-obstructive coronary artery disease(NO-CAD).Methods:41 patients with NO-CAD and 39 normal control subjects were evaluated from inpatient cardiovascular patients in the first hospital of Nanping City between June 2018 and June 2019.The plasma Lp-PLA2 was measured by immunochromatography of double-antibody sandwich.Meanwhile,total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),uric acid(UA),and hypersensitive C-reactive protein(hs-CRP)were also determined in all subjects.Results:The concentrations of plasma Lp-PLA2,LDL-C,hs-CRP were significantly higher in NO-CAD group than those in control group(P<0.05).Lp-PLA2 was positively correlated with LDL-C,hs-CRP(r=0.314,P<0.05;r=0.479,P<0.05).Logistic regression analysis showed that Lp-PLA2 was an independent risk factor for patients with NO-CAD(OR=1.022,95%CI:1.005~1.039,P<0.05).Conclusion:It suggests that the Lp-PLA2 may be an independent risk factor for patients with NO-CAD.Meanwhile,inflammation may be involved in the development of NO-CAD.