稳定性冠心病患者血清脂蛋白相关磷脂酶A2水平与冠状动脉病变程度的关系分析

Relationship between serum lipoprotein associated phospholipase A2 levels and severity of coronary artery disease in patients with stable coronary artery disease

目的 :探讨稳定性冠心病(SCAD)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平与冠状动脉病变程度的关系。方法 :选择冠状动脉造影(CAG)确诊的冠心病住院患者480例,其中SCAD患者218例(SCAD组),急性冠状动脉综合征组(ACS)262例(ACS组),选取无心脏病史或疑似心脏病但经CAG检查未非冠心病患者186例作为非冠心病组,采用免疫增强比浊法检测血清Lp-PLA2水平。结果 :ACS组患者Lp-PLA2水平、Gensini积分高于SCAD组、非冠心病组,其中SCAD组高于非冠心病组,组间比较差异有统计学意义;SCAD组三支冠脉病变患者Lp-PLA2水平高于单支、双支冠脉病变患者,其中双支冠脉病变患者高于单支,组间比较差异有统计学意义;Gensini积分≥40分患者Lp-PLA2水平高于Gensini积分<20分、20~39分的患者,其中Gensini积分为20~39分患者高于Gensini积分<20分的患者,组间比较差异有统计学意义;SCAD组不稳定型斑块患者Lp-PLA2水平高于无斑块、稳定型斑块患者,稳定型斑块患者高于无斑块患者,组间比较差异有统计学意义;Pearson相关分析显示,Lp-PLA2水平与病变支数、Gensini积分呈正相关关系。结论 :SCAD患者血清Lp-PLA2较非冠心病患者升高,与冠状动脉病变程度呈正相关关系,且可反映斑块的不稳定性。

Objective To investigate the relationship between serum lipoprotein associated phospholipase A2(Lp-PLA2) levels and severity of coronary artery disease in patients with stable coronary artery disease(SCAD). Methods 480 cases of patients with coronary heart disease(CHD) diagnosed by coronary angiography(CAG) were enrolled in the study. Among them, there were 218 patients with SCAD(SCAD group) and 262 patients with acute coronary syndrome(ACS)(ACS group).186 cases of patients without history of heart disease or suspected heart disease and without CHD diagnosed by CAG were selected as the non-CHD group. The serumLp-PLA2 levels were determined by turbidimetric inhibition immuno assay. Results Lp-PLA2 levels and Gensini score in ACS group were higher than those in SCAD group and non-CHD group, and those in SCAD group were higher than non-CHD group. Lp-PLA2 levels in patients with three-vessel coronary artery disease in SCAD group were higher than those in patients with single or double-vessel coronary artery disease, and the levels were higher in patients with double-vessel coronary artery disease than patients with single-vessel coronary artery disease. Lp-PLA2 levels in patients with Gensini score ≥40 points were higher than those in patients with Gensini score < 20 points and Gensini score of 20~39 points, and the levels were higher in patients with Gensini score of 20~39 points than patients with Gensini score < 20 points. LpPLA2 levels in patients with unstable plaques in SCAD group were higher than those in patients without plaques and patients with stable plaques, and the levels were higher in patients with stable plaques than those without plaques. Pearson correlation analysis showed that Lp-PLA2 level was positively correlated with the number of lesions and Gensini score. Conclusion The serumLp-PLA2 level in patients with SCAD is higher than that in patients without CHD. The level is positively correlated with the severity of coronary artery disease, and can reflect the instability of plaque.