老年人脂蛋白相关磷脂酶A2与冠心病冠状动脉病变程度及危险因素的关系

目的 观察老年人脂蛋白相关磷脂酶A2(Lp-PLA2)水平与冠心病冠状动脉造影病变程度及冠心病危险因素的关系. 方法 测定90例临床怀疑冠心病行冠状动脉造影老年患者Lp-PLA2、超敏C反应蛋白(hs-CRP),血脂等指标,根据冠状动脉造影结果以病变支数及Gensini积分评价冠状动脉病变程度,分析Lp-PLA2与冠心病的关系. 结果冠心病组Lp-PLA2水平较对照组明显升高[(352.7±129.0)μg/L与(204.0±59.7)μg/L,P<0.01].Lp-PLA2水平随着冠状动脉病变支数和Gensini积分的增加而升高.Lp-PLA2与年龄(r=0.25,P<0.05)、三酰甘油(r=0.33,P<0.01)、低密度脂蛋白胆固醇(r=0.27,P<0.05)、载脂蛋白B(r=0.36,P<0.01)呈正相关.在冠心病组,Lp-PLA2与年龄呈正相关(r=0.29,P<0.05).Stepwise回归分析结果显示Lp-PLA2与冠心病相关. 结论 冠心病患者Lp-PLA2水平升高,其水平的高低可能反映冠状动脉病变的严重程度.为冠心病的危险因素之一.

Association of lipoprotein-associated phospholipase A2 levels with coronary artery disease, extent of angiographic coronary artery lesions and risk factors in the elderly

Objective To observe the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) levels and coronary artery disease (CAD), extent of angiographic coronary artery lesions and risk factors of CAD in the elderly. Methods Plasma levels of Lp-PLA2, triglyceride (TG), total cholesterol(TC), low density lipoprotein(LDL-C), high density lipoprotein cholesterol (HDL-C) and high sensitivity C-reactive protein(hs-CRP) were measured in 67 elderly patients with angiographic CAD meanwhile in 23 normal controls without angiographic coronary artery lesions. The extent of coronary artery lesions was evaluated according to the number of vessel lesions (divided into single, double and triple-vessel lesions) and Gensini scoring system. Then the relationship between Lp-PLA2 and CAD was assessed. Results The plasma levels of Lp-PLA2 were significantly higher in the CAD group than in the controls [(352.7 ± 129.0) vs. (204.0 ± 59. 7) μg/L, P < 0. 01]. Lp-PLA2 levels increased with the number of coronary artery lesions and Gensini score, then were positively correlated with age(r= 0. 25, P<0. 05) ,TC(r=0. 33, P<0. 01) ,LDL-C(r=0.27, P< 0. 05),apoB(r=0. 36, P<0. 01). The levels of LP-PLA2 and LP(a) were associated with CAD by using stepwise regression analysis. Conclusions In the eldly, the levels of LP-PLA2 are much higher in angiographic CAD, and these may reflect the severity of CAD. LP-PLA2 is a risk factor for CAD.