冠心病患者血清超敏C反应蛋白及脂蛋白相关磷脂酶A2水平与冠心病纤维脂质斑块纤维帽厚度的关系

The relationship between serum hypersensitive C-reactive protein and lipoprorein-assoeiated phosPhohPaseA2 levels in patients with coronary heart disease and the thickness of fi brous cap of fibrolipid plaques in coronary heart disease

目的 探讨冠心病患者血清超敏C反应蛋白(hs-CRP)及脂蛋白相关磷脂酶A2(LpPLA2)水平与冠心病纤维脂质斑块纤维帽厚度的关系。方法 纳入首都医科大学附属北京潞河医院心内科于2014年1月至2018年1月收治的178例住院并行冠状动脉造影检查确诊冠心病患者,根据临床综合诊断信息将其分为不稳定型心绞痛组(83例)、稳定型心绞痛组(52例)和急性心肌梗死组(43例)。患者均采用光学相干断层成像(OCT)技术评价冠状动脉内的纤维帽厚度,并采集空腹静脉血测定血清hsCRP及Lp-PLA2水平,以65μm为冠心病纤维脂质斑块纤维帽厚度界限值,分析血清hs-CRP、Lp-PLA2水平与冠心病纤维脂质斑块纤维帽厚度的关系。结果 三组hs-CRP、Lp-PLA2和纤维脂质斑块纤维帽厚度水平两两比较,差异均有统计学意义(均P<0.05)。纤维脂质斑块纤维帽厚度≤65μm患者(59例)的hsCRP[(7.12±2.13)mg/L比(2.31±0.73)mg/L,t=22.196,P<0.001]、Lp-PLA2[(321.57±57.36)IU/L比(178.57±34.72)IU/L,t=20.645,P<0.001]水平均高于>65μm患者(119例),差异均有统计学意义。冠心病患者血清hs-CRP(r=–0.613,P<0.001)及Lp-PLA2水平(r=–0.604,P<0.001)与冠心病纤维脂质斑块纤维帽厚度呈负相关。结论 冠心病患者血清hs-CRP和Lp-PLA2水平与纤维脂质斑块纤维帽厚度均呈负相关,二者均可作为冠状动脉粥样硬化斑块状态的评估因子。

Objective To investigate the relationship between the levels of serum hypersensitive C-reactive protein(hs-CRP)and lipoprorein-assoeiated phosPhohPaseA2(Lp-PLA2)in patients with coronary heart disease and the thickness of the fibrous cap of fibrolipid plaques. Methods A total of 178hospitalized patients with coronary heart disease diagnosed by coronary angiography in the Department of Cardiology of our hospital from January 2014 to January 2018 were selected. According to the comprehensive clinical diagnosis information,they were divided into unstable angina group(group A,n=83), stable angina group(group B,n=52) and acute myocardial infarction group(Group C,n=43).Optical coherence tomography(OCT) was used to evaluate the thickness of fibrous cap. Fasting venous blood was collected to determine the levels of serum hs-CRP and Lp-PLA2. 65 μM was the limit value of fi brous cap thickness of fibrous lipid plaque in coronary heart disease and the relationship between serum hs-CRP and Lp-PLA2 levels and fi brous cap thickness of fi brous lipid plaque in coronary heart disease was analyzed. Results The three groups of hs-CRP, Lp-PLA2 and fibrolipid plaque fibrous cap thickness levels were compared in pairs, and the differences were all statistically significant(all P<0.05). The levels of hsCRP[(7.12±2.13)mg/L vs.(2.31±0.73)mg/L,t=22.196,P<0.001] and Lp-PLA2[(321.57±57.36)IU/L vs.(178.57±34.72)IU/L,t=20.645,P<0.001] in patients with fibrolipid plaques with a fi brous cap thickness≤65 μm were higher than those of patients>65 μm. The serum hs-CRP and Lp-PLA2 levels of CHD patients were negatively correlated with the thickness of the fi brolipid plaque fi brous cap of coronary heart disease(r=–0.613,–0.604, respectively,both P<0.001). Conclusions Serum hs-CRP and Lp-PLA2 levels in patients with CHD are negatively correlated with fi brolipid plaque fi brous cap thickness,both of which can be used as evaluation factors for coronary atherosclerotic plaque status.