不稳定型心绞痛患者氧化低密度脂蛋白自身抗体及高敏C反应蛋白升高的意义

目的探讨血清氧化型低密度脂蛋白自身抗体（Ab—ox—LDL）及高敏C反应蛋白（hs—CRP）水平与冠心病患者病变稳定性及病变程度的关系。方法根据临床诊断标准和冠状动脉造影检查结果，将79名患者分为对照组、不稳定型心绞痛组和稳定型心绞痛组3组，采用ELISA法测定血清Ab—ox—LDL浓度。结果不稳定型心绞痛组血清Ab—ox—LDL及hs—CRP水平明显高于稳定性心绞痛和对照组（P〈0．01），稳定型心绞痛组Ab—ox—LDL及hs—CRP水平高于对照组（P〈0．01）；Ab—ox—LDL和hs—CRP在对照组无相关性（r=0．302，P〉0．05），在冠心病组呈高度正相关（r=0．706，P〈0．01）；在冠心病组，Ab—ox—LDL与Gensini积分呈低度相关（r=0．362，P〈0．05）；Logistic回归分析发现血清Ab—ox—LDL及hs—CRP水平与不稳定型心绞痛呈正相关。结论血清Ab—ox—LDL及hs—CRP水平不仅反映冠心病患者病变的严重程度，而且可以评价冠心病斑块的稳定性，二者在冠状动脉硬化进程中可能起着重要的作用。

The increased levels of serum autoantibody against oxidized low density lipoprotein and C reactive protein in patients with unstable angina pectoris

Objective To investigate the relationship of the antibody against oxidized low density lipoprotein (Ab-ox-LDL) and high-sensitivity C-reactive protein (hs-CRP) with the plaque stability in coronary artery disease (CAD).Methods Serum Ab-ox-LDL and hs-CRP levels were measured by enzyme-linked immunosorbent assay in 79 patients, who were divided into 3 groups: stable angina pectoris (SAP,n=24), unstable angina pectoris (UAP,n=26) and non-CAD control (CON,n=27).Results The Ab-ox-LDL and hs-CRP levels were higher in the CAD patients than in the controls (P<0.01); and were higher in UAP patients than in SAP patients (P<0.01). Significant positive correlation between Ab-ox-LDL and hs-CRP was found in patients with CAD (r=0.706,P<0.01), but not in the controls (r=0.302,P> 0.05). Low correlation between Ab-ox-LDL and Gensini' integra was found in CAD patients (r=0.362,P<0.05). Logistic study revealed serum Ab-ox-LDL and hs-CRP were positively correlated with UAP.Conclusion These results partially illustrate the relation between chronic inflammation, autoimmunity and CAD. Serum Ab-ox-LDL and hs-CRP can reflect the severity of atherosclerotic CAD, and the stability of plaque as well. Ab-ox-LDL and hs-CRP may play important roles in the development of atherosclerosis.