脂蛋白相关磷脂酶A2与冠心病和2型糖尿病的关系

目的：探讨脂蛋白相关磷脂酶A2（Lp-PLA2）与冠心病（CHD）和2型糖尿病（T2DM）的关系.方法：入选患者200例,分为4组,CHD组80例,T2DM组20例,CHD＋T2DM组60例,对照组（非CHD非T2DM组）40例.检测Lp-PLA2及C反应蛋白（CRP）.采用析因设计方差分析研究Lp-PLA2及CRP与CHD和T2DM的相关性.同时分析CHD合并T2DM患者Lp-PLA2水平与冠脉病变程度的相关性.结果：CHD组、T2DM组、CHD＋T2DM组Lp-PLA2及CRP均高于对照组（均P＜0.05）,且经析因设计方差分析显示CHD和T2DM在CRP及Lp-PLA2升高方面有交互作用（F=7.62,P＜0.05;F=9.68,P＜0.05）.CHD＋T2DM组冠脉Gensini积分大于CHD组（44.15±36.28 vs 60.51±42.58,P=0.020）.CHD组Lp-PLA2水平与Gensini积分呈正相关（r=0.181,P=0.016）,CHD＋T2DM组Lp-PLA2水平与Gensini积分也呈正相关（r=0.224,P=0.0 11）,且后者相关性更好.结论：CHD和T2DM在CRP及Lp-PLA2升高方面有交互作用;与单纯CHD患者相比,CHD合并T2DM患者Lp-PLA2水平更高,冠脉病变更重.

Relationship between lipoprotein-associated phospholipase A2 and coronary heart disease as well as type 2 diabetes mellitus

Objective：To explore the relationship between lipoprotein-associated phospholipase A2 （Lp-PLA2） and coronary heart disease （CHD） as well as type 2 diabetes mellitus （T2DM）.Methods：Two hundred patients were enrolled in the study,and were subdivided into four groups.Factorial analysis of variance was used to study the relationships between Lp-PLA2 and CHD as well as T2DM,and the relationships between C-reaction protein （CRP） and CHD as well as T2DM.And the correlation between the level of Lp-PLA2 and the severity of coronary atherosclerosis of patients with CHD and T2DM was calculated.Results：The levels of CRP of CHD group,T2DM group,and CHD＋T2DM group were all higher than those of the control group （all P〈0.05）.So was the level of Lp-PLA2 （all P〈0.05）.Factorial analysis of variance showed CHD and T2DM could interact with CRP and Lp-PLA2 （F=7.62,P〈0.05; F=9.68,P〈0.05）.The Gensini score of CHD＋T2DM group was higher than that of CHD group （44.15±36.28 vs 60.51±42.58,P=0.020）.The level of Lp-PLA2 was positively correlated with the Gensini score in the CHD group （r=0.181,P=0.016）.And so was the levels of Lp-PLA2 in the CHD＋T2DM group （r=0.224,P=0.011）.Conclusion：CHD and T2DM can interact with CRP and Lp-PLA2.Compared with the patients with coronary heart disease alone,the level of Lp-PLA2 is higher and the coronary atherosclerosis is more severe for the patients with coronary heart disease and type 2 diabetes.