摘要
目的:观察冠心病患者血清脂蛋白相关磷脂酶A2(LP-PLA2)及游离脂肪酸(NEFA)水平,并分析该指标变化与冠状动脉病变特征和经皮静脉介入(PCI)术后预后的相关性。方法:选取心内科住院患者589例,根据冠脉造影结果将其分为对照组(189例)、单支病变组(117例)、双支病变组(126例)和多支病变组(157例)。其中有166例患者行PCI术,采集所有研究对象空腹肘静脉血,并分别采集行PCI术患者术前、术后6h、术后12h、术后24h和术后48h血液样本,采用全自动生化分析仪检测血清LP-PLA2和NEFA水平。比较各组患者以及PCI术患者不同时点血清LP-PLA2和NEFA水平差异。结果:血清LP-PLA2水平在单支病变组(351.77±103.26U/L)、双支病变组(409.14±196.34U/L)及多支病变组(823.65±369.94U/L)均高于对照组(209.34±87.32U/L),差异均有统计学意义(P<0.01),且呈多支病变组>双支病变>单支病变组,差异亦均有统计学意义(P<0.01)。血清NEFA水平在多支病变组(1.22±0.83mmol/L)、双支病变组(0.92±0.49mmol/L)和单支病变组(0.56±0.13mmol/L)均高于对照组(0.23±0.07mmol/L),差异均有统计学意义(P<0.01),且呈多支病变组>双支病变组>单支病变组,差异亦均有统计学意义(P<0.01)。LP-PLA2和NEFA与冠脉病变支数呈显著正相关(r=0.698、0.626,P<0.01)。行PCI术患者术后6h血清LP-PLA2水平较术前升高(644.64±361.34U/L vs 286.12±188.32U/L,P<0.01),术后12h下降(452.57±245.56U/L),术后24h(385.23±132.47U/L)和术后48h(325.78±144.97U/L)持续下降,各时点差异均有统计学意义(P<0.01)。PCI术患者各时点血清NEFA水平无显著差异(P>0.05)。结论:血清LP-PLA2和NEFA水平与冠心病患者冠脉病变累及支数相关,对评估冠状动脉病变的严重程度有重要的临床意义。
Objective： To investigate the serum lipoprotein associated phospholipase A2 （LP-PLA2） and non- esterified fatty acid （NEFA） level of coronary heart disease （CHD） patients, and explore the relation between the indexes and pathologic characters of CHD and postoperative prognosis of percutaneous coronary intervention （PCI）. Method： According to the results of coronary angiography, the total 589 experimental subjects come from department of cardiovascular medicine were divided into four groups： 189 for control subjects, 117 for single-vessel disease group, 126 for double-vessel disease group and 157 for multi-vessel disease group. The blood samples were collected from the venous blood of the elbow of every patients. In the meanwhile, the blood samples of 166 patients who underwent PCI surgery were collected before the surgery, 6 hours after, 12 hours after, 24 hours after and 48 hours after the surgery, and the level of serum LP-PLA2 and NEFAievel were detected by Automatic biochemical analyzer. The differences in serum PLP-PLA2 and NAFE level were compared between different groups of patients and patients with PCI. Results： Com- pared with the group of control（209. 34±87.32U/L）, the serum level of LP-PLA2 in the group of single-vessel disease （351. 77±103.26 U/L） and the group of double-vessel disease （409.14±196.34U/L） and the group of multi-vessel disease （823.65±369.94 U/L） are significantly higher（P〈0.01） , and the group of multi-vessel disease〉the group of double-vessel disease the group of single-vessel disease . The serum level of NEFA in the group of multi-vessel disease（0. 9210.49mmol/L）and the group of double-vessel disease （0.56 t 0.13mmol/L）and the group of single-vessel disease （1.22±0.8mmol/L） are significantly higher then the group of control subjects（0.23±0.07mmol/L）（P〈0.01）. And the group of multi-vessel disease 〉 the group of double-vessel disease 〉 the group of single-vessel disease. In addition, compared with the control subjects, the serum LP-PLA2 level after the PCI surgery 6 hours （644. 64±361.34U/L vs 286.12±188.32U/L,P〈0.01） is significantly higher before the surgery, and after 12 hours of the surgery（452.57±245.56U/L）, and 24 hours of the surgery （385.23±132.47U/ L） and 48 hours of the surgery （325.78±144.97U/L）, are continue to decrease, which is statistically significant difference compared with each other （P〈0.01）. There is no significant difference of the serum level of NEFA before and after the PCI operation（P〉0.05）. Conclusion： The serum levels of LP-PLA2 and NEFA are closely associated with endothelial dysfunction andvascular endothelial function and arterial wall which have important clinical significance in assessment of the lesion severity of coronary arter in CHD patients.
出处
《微循环学杂志》
2017年第4期39-42,共4页
Chinese Journal of Microcirculation
基金
国家自然科学青年基金(81501815)
关键词
血清脂蛋白相关磷脂酶A2
游离脂肪酸
冠心病
Lipoprotein associated phospholipase A2
Non-esterified fatty acid
Coronary heart disease
作者简介
通讯作者，E-mail；yanliff1120@163．com
