急性ST段抬高型心肌梗死患者血清氧化低密度脂蛋白抗体IgM水平与冠状动脉病变程度的相关研究

目的探讨急性ST段抬高型心肌梗死(STEMI)患者血清氧化低密度脂蛋白抗体IgM(ox-LDL-Ab IgM)水平与冠状动脉病变程度的相关性。方法诊断明确并行急诊经皮冠状动脉介入治疗的STEMI患者95例,经冠状动脉造影检查明确诊断的不稳定型心绞痛(UAP)患者58例,冠状动脉造影正常患者38例为对照组。STEMI组根据冠状动脉造影结果分为单支病变组、双支病变组及三支病变组,并以Gensini积分评价冠状动脉狭窄程度,分别测定血清ox-LDL-Ab IgM水平,分析ox-LDL-Ab IgM水平与冠状动脉病变程度的关系。结果 UAP组、STEMI组的ox-LDL-Ab IgM水平均低于对照组(均为P<0.01),UAP组与STEMI组间差异无统计学意义(P=0.130);STEMI组血清ox-LDL-Ab IgM水平随冠状动脉病变支数增加而降低(P=0.000),但与Gensini积分未见相关性(P=0.212);ox-LDLAb IgM水平与丙二醛水平呈显著负相关性(r=-0.319,P=0.002)。结论血清ox-LDL-Ab IgM水平可在一定程度上反映STEMI患者冠状动脉病变的严重程度;它可能具有对抗动脉粥样硬化的作用。

Relationship between serum antibody against oxidized low-density lipoprotein and coronary lesions inpatients with ST-segment elevation acute myocardial infarction

Objective To investigate the association between serum IgM antibody against oxidized low-density lipoprotein （ox-LDL-Ab IgM） and coronary lesions in patients with ST-segment elevation acute myocardial infarction （STEMI）. Methods A total of 95 patients with STEMI, 58 patients with unstable angina pectoris （UAP）, and 38 healthy patients who underwent coronary angiography （CAG） were enrolled in this study. Patients with STEMI were divided into single-, double- and triple-vessel lesion group according to the number of vessels with significant stenosis. Ox-LDL-Ab IgM was measured and Gensini＇ s score calculated for all patients. Results The ox-LDL-Ab IgM levels were similar between UAP and STEMI groups （P =0. 130）, but significantly lower than in control group （P 〈 0. 01 ）. In STEMI group, serum ox-LDL-Ab IgM level was significantly decreased with the increase of number of diseased vessels （P = 0. 000）. Spearman correlation analysis showed that ox-LDL-Ab IgM level was not correlated with Gensini＇s score （ P = 0. 212 ）, but significantly negatively correlated with MDA （ r = - 0. 319, P = 0. 002 ）. Conclusions The serum level of ox-LDL-Ab IgM can reflect the severity of atherosclerosis in patients with STEMI. Ox-LDL-Ab IgM may have a protective effect in patients with STEMI.