内皮脂肪酶检测在冠状动脉粥样硬化性心脏病患者中的意义

目的结合血清高敏C反应蛋白（high—sensitivityC—reactionprotein，hs．CRP），探讨血清内皮脂肪酶（endotheliallipase，EL）与冠状动脉粥样硬化性心脏病（冠心病）及冠状动脉病变程度的关系。方法对入选对象行冠状动脉造影，同步进行心电图、外周血EL、hs—CRP、肌酸激酶同工酶、心肌肌钙蛋白I参数检测和常规身体检查后设正常对照组（30例）和冠心病组（85例）；再将冠心病组分为稳定型心绞痛亚组（39例）、急性冠脉综合征亚组（46例）；同时也将85例冠心病患者分为冠状动脉单支病变（34例）亚组与多支病变（51例）亚组。比较组间外周血EL、hs．CRP浓度差异，评价两者在冠心病患者中的相关性及其与冠状动脉病变程度的相关性。结果冠心病组血清EL、hs—CRP浓度显著高于正常对照组，差异有统计学意义EL：（762．91±72．62）μg／Lvs（368．23＋42．14）μg／L，P〈0．05：hs—CRP：（12．76±3．08）mg／Lvs（2．34±1．53）mg／L，P〈0．05]。急性冠脉综合征组血清EL及hs．CRP浓度显著高于稳定型心绞痛组，差异有统计学意义（856．44±36．85）μg／Lvs（478．26±24．53）μg／L，P〈0．05；（21．89±4．36）mg／Lvs（5．76±6．21）mg／L，P〈0．05]。冠心病组中，51例冠状动脉多支病变患者血清EL浓度明显高于34例单支病变患者，差异有统计学意义（817．98±51．53）μg／Lvs（705．42±34．61）μg／L，P〈0．05]。所有患者血清EL浓度与hs．CRP浓度呈正相关（r=0．327，P=0．02）。结论EL在预测冠心病中有重要价值，它们在冠心病外周血中浓度的升高可以提示冠状动脉粥样斑块的不稳定，且在预测冠状动脉病变程度方面也有一定作用。

Clinical value of endothelial lipase in patients with coronary artery disease

Objectives To determine the clinical value of endothelial lipase （EL）, as well as the relationship between serum level of EL and severity of coronary artery disease combined with high-sensitivity C-reactive protein （hs-CRP）. Methods All the subjects underwent coronary angiography and their serum concentrations of EL,hs-CRP,creatine kinase isoenzyme MB and cardiac troponin I were measured. According to diagnostic results, all the cases were divided into two groups： 30 cases in normal control group and 85 cases in coronary artery disease group. Cases with coronary artery disease were furtherly divided into two subgroups：39 cases in stable angina pectoris subgroup and 46 cases in acute coronary syndrome subgroup. At the same time, cases in coronary artery disease group were also divided into single-vessel coronary artery disease subgroup （ 1 branch, 34 cases） and multivessel coronary artery disease subgroup （≥ 2 branches or left trunk,51 cases）. Serum concentrations of EL and hs-CRP among the patients were compared and relationship between them and the severity of coronary artery disease were evaluated. Results Serum concentrations of EL and hs-CRP of coronary artery disease group were significantly higher than those of normal control group EL： （762.91±72.62）μg/L vs. （368.23±42.14）μg/L, P〈0.05; hs-CRP： （12.76±3.08）mg/Lvs. （2.34±1.53）mg/L,P〈0.05]. Serum concentrations of EL and hs-CRP of acute coronary syndrome subgroup were statistically higher than those of stable angina pectoris subgroup （ 856.44±36.85 ） μg/L vs. （478.26±24.53）μg/L, P〈0.05 ; （ 21.89±4.36 ） mg/L vs. （ 5.76±6.21 ） μg/L, P〈0.05 ]. Serum concentrations of EL of muhivessel coronary artery disease subgroup were significantly higher than those of single vessel coronary artery disease subgroup （ 817.98 ±51.53 ）μg/L vs. （705.42±34.61 ）μg/L, P 〈0.05 ]. Serum concentrations of EL in all the patients were positively correlated with serum concentrations of hs-CRP （r=0.327 ,P=0.02）. Conclusions Increased serum concentrations of EL in patients with coronary artery disease may predict the unstable conditions of plaques. EL plays a role in predicting the severity of coronary artery disease to some extent.