氧化低密度脂蛋白抗体水平与冠状动脉再狭窄的相关性:独立于年龄、性别、体质量指数、高血压、高血脂及吸烟史的危险因子

Relationships between levels of antibody against oxidized low density lipoproteins and restenosis of coronary artery:risk factor independent from age,sex,bodyma ss index hypertension,hyperlipemia and smoking history

目的:探讨非糖尿病人群中血氧化低密度脂蛋白(oxidizedlowdensitylipoproteins,ox-LDL)抗体与经皮冠状动脉成形术(percutaneoustranslu-milarcoronaryangioplasty,PTCA)后临床再狭窄的联系,阐明ox-LDL抗体预测再狭窄的意义。方法:冠脉造影确定为单处病变的非糖尿病不稳定心绞痛(unstableangina,UA)患者41例,分别于PTCA术前、后留取外周血检测ox-LDL抗体、高敏感C反应蛋白(highsensitiveC-reactiveprotein,hs-CRP)等。术后随访6个月,随访内容包括:胸痛,静息或症状发作时心电图(electrocardiogram,ECG),和(或)负荷ECG及心肌核素灌注显像,必要时行冠状动脉造影(coronaryangiography,CAG),综合判断临床再狭窄。结果:41例患者中,术后6个月内发生临床再狭窄11例,发生率26.8%。再狭窄组术前CRP值较非再狭窄组显著升高(P=0.03)。两组术后C反应蛋白(C-reactiveprotein,CRP)值与术前比较,差异无显著性意义(P>0.05)。再狭窄组术前ox-LDL抗体较非再狭窄组显著增高(P=0.008)。术后1周时,再狭窄组ox-LDL抗体水平较术前显著增高近1倍(P<0.001),而非再狭窄组术前、术后差异无显著性意义(P>0.05)。Logistic回归分析显示,术前血清ox-LDL抗体与临床再狭窄发生显著正相关(OR=2.663,CIof95%forOR1.149,6.974,χ2=16.688,P<0.

AIM:To explore the relation between antibody against oxidized low density lip oproteins(ox- LDL) and clinical restenosis after percutaneous translumilar coro nary angioplasty(PTCA) in patients without diabetes,clarify the meaning of predi cting restenosis by ox- LDL antibody. METHODS:The prospective study was undertaken in 41 non- diabetic subjects wi th unstable angina(UA),who were verified to be with single- lesion coronary dis ease by coronary artery opacification,their peripheral blood was taken before an d after PTCA respectively, for detection of ox- LDL antibody, high sensitive C - reactive protein( hs- CRP) ,et al.These patients were followed- up for 6 months by clinical syndromes, including chest pain, electrocardiogram(ECG) of re sting or symptom episoding, ECG of loading or myocardium perfusion image(MPI),co ronary angiography(CAG)was adopted when necessary,clinical restenosis was judged synthetically. RESULTS:By the end of six- month followed- up, clinical restenosis develope d in 11 of 41 patients(26.8% ). The level of CRP antibody in restenosis group p reoperative was significantly higher compared with that in non- restenosis grou p(P=0.03).There was no significant difference of CRP level in both group before and after the operation(P >0.05).Compared with non- restenosis group,preoperati ve ox- LDL antibody level in restenosis group was significantly increased(P=0.0 08).One week after operation, ox- LDL antibody level in restenosis group had in creased by almost 1 time( P< 0.001) , while the difference of non- restenosis group before and after the operation was not obvious( P >0.05) .Logistic regr ession analysis showed that elevated level of ox- LDL antibody was positively c orrelated significantly with restenosis,( OR=2.663,CI of 95% for OR[1.149,6.9 74], ÷ 2=16.688, P< 0.001) , independent of age,gender,body mass index,hypert ension,hyperlipemia lipid disorder, smoking history and hs- CRP levels. CONCLUSION:Preoperative level of ox- LDL antibody in nondiabetic subjects is a helpful predictive factor for development of clinical restenosis.