彭吉新,单守杰,刘志忠,张俊杰,金国珍

• 1:江宁中医院心病科
• 2:南京医科大学附属南京医院心内科

摘要(Abstract)：

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)与不稳定型心绞痛(UAP)罪犯病变组织学特征的关系。方法连续选取2014年5月至2016年10月在南京医科大学附属南京医院62例UAP患者,根据入院时UAP危险分层将患者分为高危UAP组(24例)和中低危UAP组(38例),对罪犯病变行冠状动脉造影和彩色编码血管内超声(iMAP-IVUS)检查。采用免疫比浊法测定血浆Lp-PLA2水平,分析不同Lp-PLA2水平UAP患者罪犯病变的组织学特征。结果高危UAP组患者Lp-PLA2水平[(598.2±102.3)ng/ml比(303.9±91.6)ng/ml,P=0.003]高于中低危UAP组患者。Lp-PLA2为485.3 ng/ml时,其判别高危UAP的敏感度为87.5%,特异度为89.5%。高Lp-PLA2组(Lp-PLA2≥485.3 ng/ml)患者最小管腔处外弹力膜面积、斑块面积和斑块负荷,正性重构,富含脂质斑块及斑块破裂的比例均显著高于低Lp-PLA2组差异均有统计学意义(均P<0.05)。logistic多因素回归分析显示,Lp-PLA2≥485.3 ng/ml(OR 5.73,95%CI 2.21～12.60,P<0.001)和富含脂质斑块(OR 8.51,95%CI3.64～15.80,P<0.001)是高危UAP的独立预测因子。结论 Lp-PLA2水平与UAP斑块不稳定有关,LpPLA2≥485.3 ng/ml和富含脂质斑块是高危UAP的独立预测因子。

关键词(KeyWords)： 不稳定型心绞痛;脂蛋白相关磷脂酶A2;斑块;彩色编码血管内超声

Abstract:

Keywords:

基金项目(Foundation): 南京市卫生科技发展专项资金项目(YKK18096)

作者(Author): 彭吉新,单守杰,刘志忠,张俊杰,金国珍

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