血清淀粉样蛋白A和血清淀粉样蛋白A-低密度脂蛋白复合物与冠心病的临床研究

目的探讨血清淀粉样蛋白A(SAA)和SAA-LDL复合物与冠状动脉病变程度和心肌缺血时心功能状态之间的关系。方法选择冠心病患者93例,行冠状动脉造影时根据Gensini评分进行分组:20分为A组(32例),20～40分为B组(30例),40分为C组(31例)。经冠状动脉造影排除冠心病者30例作为对照组。测定空腹血脂、血糖,采用ELISA法测定血清SAA和SAA-LDL复合物的水平。结果 Pearson相关和多元线性回归分析显示,Gensini评分与LVEF呈负相关,与血清SAA-LDL复合物水平呈正相关,与SAA、血脂、血糖水平不相关;LVEF与SAA-LDL复合物水平呈负相关,与SAA、血脂、血糖水平不相关。单因素方差分析显示,与对照组和A组比较,B组和C组lgSAA-LDL明显升高;与B组比较,C组lgSAA-LDL明显升高(P0.05);而对照组与A组lgSAA-LDL比较差异无统计学意义(P0.05)。结论血清SAA-LDL复合物比SAA更敏感地反映心肌缺血的严重程度及心肌缺血后心脏收缩功能的状态,严重的心肌缺血可导致左心室收缩功能障碍。

Clinical study on relationship of serum amyloid A and SAA-LDL complex with coronary heart disease

Objective To explore the relationship of serum amyloid A(SAA) and SAA-LDL complex with the severity of coronary lesions and cardiac function during myocardial ischemia.Methods Ninety-three cases of coronary heart disease were randomly divided into 3 groups by Gensini score according to the results of coronary angiography:group A<20 score group (n = 32),group B 20 — 40 score group (n= 30) ,group C>40 score group (n = 31).Thirty cases without coronary heart disease proved by coronary angiography were selected as normal control group(NC group). Blood samples were obtained on the following morning after admission for measuring the fasting serum lipid and glucose.SAA and SAA-LDL complex were measured by enzyme-linked immunosorbent assay.Results The Gensini score was correlated positively with SAA-LDL complex and correlated negatively with left ventricular ejection fraction.There was no correlation between Gensini score and SAA,serum lipid or serum glucose.There was significant increase in SAA-LDL complex in group B and group C compared with group NC and group A.SAA-LDL complex was also obviously increased in group C compared with group B (P < 0.05) ,while there was no significant difference between group NC and group A (P> 0.05).Conclusion SAA-LDL complex was more sensitive than SAA for evaluating cardiac systolic function and the severity of myocardial ischemia.Severe ischemia can induce left ventricular systolic dysfunction.