冠心病患者血浆纤维蛋白原与脂蛋白相关磷脂酶A2水平

目的分析冠心病(CAD)患者血浆纤维蛋白原(Fbg)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平。方法分别检测110例急性冠脉综合征(ACS)、80例稳定性心绞痛(SAP)患者和48例健康人对照组的血浆Lp-PLA2，Fbg水平及CAD病变程度，分析其相互关系。结果与健康人对照组相比较，CAD患者Lp-PLA2，Fbg水平均显著升高，差异有统计学意义(t=4.556，8.095；均P<0.01)；与SAP组相比较，ACS组的Lp-PLA2，Fbg，Gensini积分以及cTnI水平均显著升高，差异有统计学意义(t=3.537，2.126，3.286；均P<0.05)。相关性分析显示，CAD患者血浆Lp-PLA2，Fbg均与Gensini积分(r1=0.356，r2=0.348；均P<0.01)，cTnI水平(r1=0.262，r2=0.213；均P2<0.05)呈正相关，且Lp-PLA2与Fbg亦呈正相关(r=0.203，P<0.01)。多元回归分析显示，CAD患者血浆Lp-PLA2和Fbg(β=0.263，0.204，均P<0.05)水平共同决定了10.70%的Gensini积分变化；cTNI和Fbg(β=0.484，0.293；均P<0.01)共同决定了35.00%的Lp-PLA2变化，而Lp-PLA2是Fbg的唯一显著的独立预测因子(β=0.368，P<0.01)。结论CAD患者血浆Lp-PLA2，Fbg水平升高，与动脉粥样硬化(As)病变程度密切相关，且两者相互促进相互影响。

Levels of Plasma Lipoprotein Associated Phospholipase A2 and Fibrinogen in Patients with Coronary Artery Disease

ObjectiveTo investigate the levels of plasma lipoprotein associated fibrinogen (Fbg) and phospholipase A2 (Lp-PLA2) in patients with coronary artery disease (CAD)．MethodsPlasma Fbg and Lp-PLA2 levels were measured in 110 patients with acute coronary syndromes (ACS)，80 with stable angina pectoris (SAP) and 48 healthy controls，and the Gensini score of each CAD patient was obtained．ResultsCompared to controls，the levels of Lp-PLA2 and Fbg in patients with CAD were both significantly increased (t=4.556，8.095；all P<0.01)．Furthermore，the Lp-PLA2，Fbg，cTnI levels and the Gensini score in patients with ACS were found higher than with SAP (t=3.537，2.126，3.286；all P<0.01)．Lp-PLA2 and Fbg levels were found positively related with Gensiniscore (r1=0.356，r2=0.348；all P2<0.01) and cTnI (r1=0.262，r2=0.213；all P2<0.05)，and Lp-PLA2 levels were also correlated with Fbg (r=0.203，P<0.01)．The multiple linear regression analysis showed that Lp-PLA2 and Fbg(β=0.263，0.204；all P<0.05)　accounted for 10.70% of the variation of Gensini score in patients　with CAD，and cTNI and Fbg (β=0.484，0.293；all P<0.01) accounted for 35.00% of the variation of Lp-PLA2 levels．Only Gensini score was the signi　cant independent predictor of Fbg levels (β=0.368，P<0.01) in patients with CAD．ConclusionSerum Lp-PLA2 and Fbg levels were increased and associated with the severity degree in patients with CAD．