急性心肌梗死患者经皮冠脉介入术治疗前后血清Lp-PLA2、IMA、H-FABP水平变化及意义

目的 探讨急性心肌梗死(AMI)患者经皮冠脉介入术(PCI)治疗前后血清脂蛋白相关磷脂酶A2(Lp-PLA2)、缺血修饰白蛋白(IMA)、心脏型脂肪酸结合蛋白(H-FABP)水平变化及意义.方法 选取2015年3月至2016年7月攀枝花市第二人民医院PCI治疗的120例AMI患者作为病例组(单支病变47例、双支病变43例、三支病变30例),另选取40例同期住院心衰患者(对照组),检测两组患者的血清Lp-PLA2、IMA、H-FABP水平,并分析三种指标在AMI患者PCI手术前后不同时间的变化.结果 病例组入院24 h内的血清Lp-PLA2[(209.81±38.49)mg/L]、IMA[(89.51±18.74)U/mL]、H-FABP[(26.75±4.72)μg/L],均高于对照组[(148.26±22.74)mg/L、(45.39±10.25)U/mL、(3.21±0.69)μg/L(P<0.05)];单支病变、双支病变、三支病变的AMI患者入院24 h内的血清Lp-PLA2、IMA、H-FABP水平呈逐渐升高的趋势,差异均具有统计学意义(P<0.05);病例组患者的血清H-FABP水平在术后呈逐渐降低的趋势;血清IMA在术后24 h升高,后逐渐降低;血清Lp-PLA2水平在术后72 h均呈逐渐升高的趋势,差异均具有统计学意义(P<0.05).结论 AMI患者的血清Lp-PLA2、IMA、H-FABP水平升高明显,并且与冠脉病变支数有关.

Changes and significance of serum Lp-PLA2, IMA and H-FABP levels in patients with acute myocardial infarction before and after percutaneous coronary intervention

Objective To investigate the changes of serum lipoprotein associated phospholipase A2 (Lp-PLA2), ischemia modified albumin (IMA), heart type fatty acid binding protein (H-FABP) in patients with acute myocardial infarction (AMI) before and after percutaneous coronary intervention (PCI), and to explore the clinical sig-nificance. Methods From March 2015 to July 2016, 120 patients with AMI who were treated with PCI were selected as the study group (including 47 cases of single vessel lesion, 43 cases of double vessel lesions, 30 cases of triple ves-sel lesions), and forty patients with heart failure were selected as control group. The serum Lp-PLA2, IMA and H-FABP levels were measured, and the changes of the three indexes were analyzed before and after PCI in patients with AMI. Results The serum Lp-PLA2, IMA, H-FABP levels within 24 h after admission were (209.81±38.49) mg/L, (89.51±18.74) U/mL, (26.75±4.72)μg/L in the study group, which were significantly higher than (148.26±22.74) mg/L, (45.39 ± 10.25) U/mL, (3.21 ± 0.69) μg/L in control group (P<0.05). The Lp-PLA2, IMA, H-FABP levels showed a gradual increasing trend in AMI patients with single vessel lesion, AMI patients with double vessel lesions, and those with triple vessel lesions, with statistically significant difference (P<0.05). Compared with before PCI, H-FABP levels in the study group showed a gradual decreasing trend after PCI, IMA increased 24 h after PCI and then started to decline, and Lp-PLA2 showed an increasing trend within 72 h after PCI, all with statistically signifi-cant difference (P<0.05). Conclusion The levels of serum Lp-PLA2, IMA and H-FABP in AMI patients were signifi-cantly increased, which were related to the number of coronary artery lesions.