急性冠脉综合征患者脂蛋白相关磷脂酶A2水平变化和临床意义

目的探讨急性冠脉综合征(ACS)患者脂蛋白相关磷酯酶A2(Lp-PLA2)水平变化及其与冠状动脉病变严重程度之间的关系和临床意义。方法 79例入选患者按冠状动脉造影结果分为ACS组和正常对照组,再以临床类型、冠脉病变支数、Gensini积分将ACS组患者分成不同的亚组,根据临床类型分为不稳定型心绞痛组(UA组)和急性心肌梗死组(AMI组),据冠脉病变支数分为单支病变、双支病变和三支病变组,采用ELISA法检测Lp-PLA2水平,并进行对比分析。结果 ACS组Lp-PLA2水平显著高于正常对照组(P<0.01);急性心肌梗死(AMI)亚组Lp-PLA2水平显著高于不稳定型心绞痛(UAP)亚组(P<0.01);三支病变亚组Lp-PLA2水平显著高于单支病变亚组(P<0.01),而双支病变亚组与单支病变亚组、三支病变亚组相比Lp-PLA2水平差异无统计学意义(P>0.05);随着Gensini积分的增加,Lp-PLA2水平有逐渐升高的趋势。结论 ACS组Lp-PLA2水平显著高于正常对照组,且Lp-PLA2水平可间接反映ACS患者冠脉病变的严重程度。

The clinical significance and changes of lipoprotein-associated phospho-lipaseA2 level in patients with acute coronary syndrome

Objective To discuss the relationship between the level of lipoprotein-associated phospho-lipaseA2(Lp-PLA2) and the degree of the coronary artery disease of the acute coronary syndrome (ACS) and investigate the clinical significance.Methods　All Subjects(n=79) were divided into ACS group and control group according to the results of coronary angiography(CAG), and then ACS group was divided again into different groups according to the clinical symptoms, number of diseased coronary branches and Gensini scores. The level of Lp-PLA2 was detected by ELISA in all groups and the results were compared and analysed.Results The level of Lp-PLA2 was higher significantly in ACS group than that in the control group (P<0. 01), and that was higher significantly in the group of acute myocardial infarction (AMI) than that in the group of unstable angina pectoris (UAP,P<0.01).The level of Lp-PLA2 was higher significantly in three-vessel disease subgroup than that in single-vessel disease subgroup (P<0.01),and the level of Lp-PLA2 was no significant difference among three-vessel disease sub-group and single-vessel disease sub-group, compared with the two-vessel disease sub-group(P> 0.05).With the increase of Gensini score, the level of Lp-PLA2 increased too.Conclusion　The level of Lp-PLA2 was higher significantly in ACS group than that in the control group ，and the plasma level of Lp-PLA2 may reflect indirectly the degree of the coronary artery disease of the acute coronary syndrome (ACS).