冠状动脉慢血流患者脂蛋白相关磷脂酶A2及超敏C反应蛋白的变化

Changes of lipoprotein-associated phospholipase A2 and high sensitivity C reactive protein in patients with coronary slow flow

  • 摘要:
      目的  探讨人血浆脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)水平变化及其与冠状动脉慢血流(CSF)的关系。
      方法  选取65例经冠状动脉造影证实的CSF患者(CSF组)与60例冠状动脉及血流正常人群(对照组)。采用校正的心肌梗死溶栓治疗(TIMI)血流记帧法测定冠状动脉血流速度,测定所有患者的血生化、Lp-PLA2和hs-CRP水平。
      结果  2组患者临床基础资料无显著差异(P>0.05)。与对照组相比, CSF组患者Lp-PLA2、hs-CRP和尿酸水平显著升高(P < 0.05)。CSF患者左前降支、左回旋支和右冠状动脉的校正心肌梗死溶栓治疗血流记帧法计数(TFC)和平均TFC显著更高(P < 0.01)。随着CSF中涉及的冠状动脉数量的增加, Lp-PLA2的水平逐渐增加。Logistic回归分析显示, Lp-PLA2(OR=1.009, P=0.046)、hs-CRP(OR=1.071, P=0.048)是CSF的独立预测因素,同时Lp-PLA2与hs-CRP呈显著正相关(r=0.407, P < 0.001)。以血浆Lp-PLA2水平作为测试变量, ROC曲线分析表明曲线下面积为0.676 (P < 0.05)。
      结论  与冠状动脉解剖正常人群相比, CSF患者血Lp-PLA2、hs-CRP水平较高,且是CSF的独立预测因素,较高的Lp-PLA2水平与CSF的严重程度相关。

     

    Abstract:
      Objective  To investigate the changes of plasma lipoprotein-associated phospholipase A2 (Lp-PLA2), high sensitivity C reactive protein (hs-CRP) and their relationships with coronary slow flow (CSF).
      Methods  A total of 65 CSF patients diagnosed with coronary angiography and 60 cases with normal coronary flow were selected as CSF group and control group. Coronary flow velocity was determined by the corrected blood flow framing method of thrombolytic therapy for myocardial infarction (TIMI). Plasma biochemical indexes, hs-CRP and Lp-PLA2 levels were detected in all patients.
      Results  There was no significant difference in clinical basic characteristics between two groups (P>0.05). Compared with the control group, the Lp-PLA2, hs-CRP and uric acid levels were significantly higher in CSF group (P < 0.05). The corrected TIMI frame count (TFC) for the left anterior descending artery, the left circumflex artery and the right coronary artery and the mean TFC were all significantly higher in CSF group than control group (P < 0.01). As the number of coronary arteries involved in CSF increased, the level of Lp-PLA2 gradually increased. Logistic regression analysis showed that Lp-PLA2 (OR=1.009, P=0.046) and hs-CRP (OR=1.071, P=0.048) were the independent predictors for CSF, and meanwhile, there was a significant positive correlation between Lp-PLA2 and hs-CRP (r=0.407, P < 0.001). Taking plasma Lp-PLA2 levels as the test variable, ROC curve analysis indicated that the area under the curve was 0.676 (P < 0.05).
      Conclusion  Plasma levels of Lp-PLA2 and hs-CRP are higher in patients with CSF when compared to patients with normal coronary anatomy, and Lp-PLA2 and hs-CRP are independent predictors for CSF. The higher Lp-PLA2 levels are correlated with the severity of CSF.

     

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