脂蛋白相关磷脂酶A2在冠状动脉粥样硬化性心脏病患者中的临床应用价值

目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)在冠状动脉粥样硬化性心脏病(CAD)的临床应用价值。方法采用病例对照研究,选取2013年10月至2015年6月在该院进行冠状动脉CT血管造影(CTA)检查的患者790例,根据冠状动脉CTA结果分为CAD组(352例)和无CAD对照组(438例),CAD组依据冠状动脉病变支数不同分为单支冠状动脉病变(118例)、双支冠状动脉病变(107例)和多支冠状动脉病变(132例),检测Lp-PLA2、超敏C反应蛋白(hs-CRP)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、葡萄糖(GLU)、糖化血红蛋白A1c(HbA1c)等指标进行综合分析。各组均数比较采用t检验或方差分析;不同指标相关性采用Pearson直线相关分析。结果 CAD组和对照组比较,LpPLA2、hs-CRP、年龄、GLU、HbA1c、载脂蛋白B(ApoB)水平CAD组均明显高于对照组,差异均有统计学意义(均P0.05)。LpPLA2在CAD组不同冠状动脉病变支数间比较,差异有统计学意义(F=4.941,P0.05);多支冠状动脉病变组Lp-PLA2水平高于单支冠状动脉病变组,差异有统计学意义(P0.05);多支冠状动脉病变组和双支冠状动脉病变组Lp-PLA2水平差异无统计学意义(P0.05);双支冠状动脉病变组和单支冠状动脉病变组Lp-PLA2水平差异无统计学意义(P0.05)。Lp-PLA2和HsCRP之间用Pearson直线相关分析,结果显示无相关性(r=0.042,P0.05)。结论血清Lp-PLA2水平升高是CAD的危险因素,可用于冠状动脉粥样硬化及受累血管支数的风险评估。

Clinical application value of serum lipoprotein associated phospholipaseA2 in coronary atherosclerotic heart diseases

Objective To investigate the clinical application value of serum lipoprotein associated phospholipase A2(Lp‐PLA2) in coronary atherosclerotic heart diseases(CAD) .Methods Using the case‐control study ,790 patients with coronary computed tomography angiography (CTA) in our hospital from October 2013 to June 2015 were selected and divided into the CAD group (352 cases) and control group (438 cases) according to the results of coronary artery CTA .According to the number of coronary artery lesion vessels the CAD group was re‐divided into three subgroups :single branch coronary artery lesion (118 cases) ,double branch coronary arterial lesions(n=107) and multiple branch coronary arterial lesions(132 cases) .The levels of Lp‐PLA2 ,hs‐CRP , TG ,TC ,HDL‐C ,LDL‐C ,glucose ,HbA1c and other indexes were measured and comprehensively analyzed .The t test or variance a‐nalysis was used to compare the means between or among groups .The correlation of different indicators was analyzed with the Pearson linear correlation analysis .Results Compared with the control group ,the CAD group was significantly higher than the con‐trols in the levels of Lp‐PLA2 ,hs‐CRP ,age ,GLU ,HbA1c and ApoB ,the differences were statistically significant(P<0 .05) .The Lp‐PLA2 level had statistical difference among different branch coronary artery lesions in the CAD group(F=4 .941 ,P<0 .05) ,the level of Lp‐PLA2 in the CAD group with multiple branch coronary artery disease was higher than that in single branch coronary ar‐tery disease(P<0 .05) .No statistically significant difference between multiple branch coronary artery disease and double branch coronary arteries disease was observed .No statistically significant difference between double branch coronary arteries disease and single branch coronary artery disease was observed .The Pearson linear correlation analysis showed that Lp‐PLA2 and hs‐CRP had no correlation (r=0 .042 ,P>0 .05) .Conclusion Serum Lp‐PLA2 level increase is a risk factor of CAD and could be used to assess coronary arterial atherosclerosis and number of coronary arterial lesions .