磷脂酶 A2与非ST段抬高急性冠脉综合征临床相关性研究
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江苏省科教强卫工程青年医学人才项目(QN?RC2016857);江办省自然科学基金青年基金(BK20171051);国家自然科学基金青年基金(81700331)


Association of Lp⁃PLA2 with the severity and prognosis of NSTE⁃ACS
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    目的:研究脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)与非ST段抬高急性冠脉综合征(non-ST-elevation acute coronary syndromes,NSTE-ACS)血管病变严重程度以及预后之间的关系。方法:选取南京医科大学附属江宁医院心血管内科2014年1月至2015年5月经冠脉造影术确诊的NSTE-ACS患者95例,其中不稳定性心绞痛46例,非ST段抬高型心肌梗死49例。按年龄以及性别配比选取同期冠脉造影术正常的患者62例作为对照组。根据患者冠脉病变支数分为单支病变、双支病变和三支病变组。对所有患者术后随访1年,记录相关主要心血管事件(major adverse cardiovascular events,MACE)发生情况。探讨不同Lp-PLA2水平与NSTE-ACS患者预后的关系。结果:不稳定心绞痛组以及非ST抬高心肌梗死组患者Lp-PLA2水平较对照组明显增高,其中非ST抬高心肌梗死组患者较不稳定性心绞痛组升高更为显著。此外,随着病变支数增加,血浆Lp-PLA2水平也逐渐升高。发生MACE事件组患者Lp-PLA2水平明显高于未发生MACE事件对象。结论:Lp-PLA2水平与NSTE-ACS冠状动脉病变支数有密切关系,并且Lp-PLA2水平与NSTE-ACS患者发生MACE事件相关。

    Abstract:

    Objective:The aim of the present study was to evaluate the relationship of lipoprotein-associated phospholipase A2(Lp-PLA2)with the severity and prognosis of non-ST-elevation acute coronary syndromes(NSTE-ACS). Methods:We conducted a hospital-based study to examine the potential association of Lp-PLA2 with the severity and prognosis of NSTE-ACS. A total of 157 unrelated subjects(46 UAP patients,49 Non-STEMI patients and 62 non-CAD subjects as control)who underwent elective coronary angiography from January 2014 to May 2015 admitted to Department of Cardiology,the Affiliated Jiangning Hospital of NMU. Results:We observed that the plasma levels of Lp-PLA2 were significantly higher among non-ACS patients compared to non-CAD subjects,moreover,its level is most high in Non-STEMI patients. There was also a highly remarkable association of Lp-PLA2 with double-vessel and triple-vessel disease when patients were divided into subgroups based on the number of diseased vessels. After 1-year follow up,we found that Lp-PLA2 levels were also related to events of MACE with statistical significance. Conclusion:Our results suggest that Lp-PLA2 is associated with the severity and prognosis of NSTE-ACS.

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严建军,高 伟,徐崇利,张郁青,陈广胜,连小清,周本军,李雪琦,叶笑天.磷脂酶 A2与非ST段抬高急性冠脉综合征临床相关性研究[J].南京医科大学学报(自然科学版),2018,(12):1711-1714

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  • 收稿日期:2018-05-13
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  • 在线发布日期: 2019-01-02
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