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目的了解冠心病患者分泌型磷脂酶 A2(sPLA2)的变化,并通过测定 IL-8、LPA 等相关细胞因子,对 sPLA2的作用机制进行初步探讨。方法冠状动脉造影确诊的262例患者,其中急性冠脉综合征(ACS)110例,稳定性冠心病(SCHD)63例,正常患者89例,分别测定 sPLA2、白细胞介素8(IL-8)、高敏 C 反应蛋白(hs-CRP)和溶血磷脂酸(LPA)水平,并进行对比分析。结果冠心病患者sPLA2[(68±17)U/ml]、IL-8[(182±80)pg/ml]以及 LPA[(2.85±0.36)μmol/L]均明显高于对照组[sPLA2:(55±12)U/ml,IL-8:(119±33)pg/ml,LPA:(2.34±0.36)μmol/L,均 P<0.01],其中ACS 组的 sPLA2[(71±18)U/ml]、IL-8[(195±78)pg/ml]也明显高于 SCHD 组[sPLA2:(63±12)U/ml],IL-8:[(159±79)pg/ml,均 P<0.01;sPLA2与 IL-8(r=0.203,P=0.007)、LPA(r=0.658,P<0.01)、hs-CRP(r=0.231,P=0.005)均呈正相关;sPLA2≥63.75 U/ml 时,患冠心病的相对危险度为6.248(P<0.01)。结论冠心病患者 sPLA2明显升高,它可能与 IL-8共同参与冠心病的炎症发展过程,并与下游相关产物 LPA 进一步加速其进展。提示 sPLA2升高是冠心病的独立危险因素之一。
Objective To investigate the changes of secreted phospholipase A2 (sPLA2) in patients with coronary heart disease and to explore the mechanism of action of sPLA2 by measuring cytokines such as IL-8 and LPA. Methods A total of 262 patients diagnosed by coronary angiography were enrolled in this study. Among them, 110 cases were acute coronary syndrome (ACS), 63 cases were stable coronary heart disease (SCHD) and 89 cases were normal. Serum levels of sPLA2, IL-8, , Hs-CRP and LPA were measured and compared. Results Compared with control group, sPLA2 [(68 ± 17) U / ml], IL-8 [(182 ± 80) pg / ml] and LPA (2.85 ± 0.36 μmol / L) (P <0.01). The levels of sPLA2 [(71 ± 18) U / ml, IL-8: 119 ± 33 pg / ml and LPA: 2.34 ± 0.36 μmol / L, IL-8 [(195 ± 78) pg / ml] was also significantly higher than that of the SCHD group [sPLA2: (63 ± 12) U / , All P <0.01; sPLA2 was positively correlated with IL-8 (r = 0.203, P = 0.007), LPA (r = 0.658, P <0.01) 63.75 U / ml, the relative risk of coronary heart disease was 6.248 (P <0.01). Conclusion The sPLA2 in patients with coronary heart disease was significantly higher than that in patients with coronary heart disease. It may be involved in the inflammatory process of coronary heart disease with IL-8 and further accelerate its progress with LPA. Tip sPLA2 elevated coronary heart disease is an independent risk factor.