分泌型磷脂酶A2与冠心病的关系

目的探讨分泌型磷脂酶A2（sPLA2）与冠心病的关系。方法选取心内科住院患者262例，正常者89例（对照组），稳定型心绞痛患者63例（SAP组），急性冠脉综合征患者110例（ACS组）。经桡动脉途径行冠状动脉造影计算各组研究对象的冠状动脉病变积分（CAS），并采用ELISA法检测其血清sPLA2，比较分析组间差异以及sPLA2与CAS、冠心病相关因素等的关系。结果ACS组sPLA2均显著高于SAP组及对照组（均P〈0．01），而且SAP组sPLA2也显著高于对照组（P〈0．01）。sPLA2与HDL-C呈负相关（P〈0．01），与CAS呈正相关（P〈0．01），但sPLA2与年龄、BMI、LDL—C无明显相关性（P〉0．05）。Cox回归分析结果示，sPLA2是冠心病的独立危险因素（P〈0．01），但高血压、糖尿病、吸烟等未显示出其独立危险因素的作用（P〉005）。结论sPLA2可以作为冠状动脉粥样斑块不稳定的一个预测指标，其水平升高提示病情较重、预后不良。

Correlation of circulating levels of phospholipase A2 with coronary artery syndrome

Objective To investigate the correlation of secretary type II phospholipase A2 （sPLA2） with acute coronary syndrome （ACS） and blood IL-8 and hs-CRP levels. Methods One hundred and ten patients with ACS （ACS group）, 63 patients with stable angina pectoris （SAP group） and 89 normal subjects （control group） were enrolled in the study. All subjects underwent coronary artery angiography through the radial artery, and the coronary score （CAS） was calculated. Radial artery blood samples were also taken to detect the levels of sPLA2, IL-8, hs-CRP and the other chemical index. Results The blood levels of sPLA2, IL-8 and hs-CRP in ACS group was significantly higher than those in SAP group and normal control group. The blood level of sPLA2 had a positive correlation with hs-CRP and IL-8, respectively, but a negative correlation with HDL-C. The blood sPLA2 level was an independent risk factor for the coronary heart disease. Conclusion Blood sPIA2 seems to be a predictive factor for unstable atheromatous plaque of coronary artery, the severity and poor prognosis of patients with coronary heart disease.