摘要目的 探讨冠心病患者的脂蛋白相关磷脂酶A2(1 ipoprotein associated phospholipase A2,LpPLA2)、超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)和D-二聚体的相关性情况,从而为临床提供更多的参考价值.方法 选择2014年1月至2016年1月期间在荷泽市立医院急诊就诊的150例冠心病患者作为观察组,并取同时期的130例健康志愿者作为对照组,对入组者的血清Lp-PLA2、hsCRP以及D-二聚体进行检测.同时对其低密度脂蛋白(low density lipoprotein,LDL)、肌钙蛋白(Cardian troponin I,TNI)、肌红蛋白(myoglobin,Myo)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)进行检测.结果 观察组患者的Lp-PLA2、hs-CRP以及D-二聚体水平分别是(43.62±13.23) g/L、5.09 mg/L、173.0 mg/L,明显高于对照组志愿者的(21.49±7.63) g/L、2.61 mg/L、68.0 mg/L,差异有统计学意义(P＜0.05).观察组的Lp-PLA2与LDL密切相关,并和冠脉病变的支数相关;D-二聚体和hs-CRP相关,同时和心功能等级相关.结论 Lp-PLA2主要和LDL等脂类代谢以及冠脉病变的程度密切相关,hs-CRP则是和D-二聚体水平以及心肌损伤标志物有密切关联,说明了炎症和血栓、心肌损伤有关.心功能降低容易导致D-二聚体水平升高从而诱发血栓.因此,对于冠心病患者,可以通过Lp-PLA2、hs-CRP以及D-二聚体水平指标来预测其预后情况.

abstractsObjective To investigate the relationship between blood lipoprotein associated phospholipase A2,hypersensitive C reactive protein and D-two dimer in patients with coronary heart disease,so as to provide more reference for clinical treatment.Methods 150 cases of coronary heart disease patients enrolled in department of emergency of our hospital from January 2014 to January 2016 were selected as the observation group,while 130 healthy volunteers from the same period were selected as the control group.Serum Lp-PLA2,hs-CRP and D-two dimers in each group were detected in the study,and the degree of low density lipoprotein cholesterol (LDL),cardiac troponin I (TNI),myoglobin (Myo),creatine kinase isoenzyme (CK-MB) were also detected.Results Lp-PLA2,hs-CRP and D-two dimer level in the observation group was (43.62 ± 13.23)g/L,5.09 mg/L,173.0 mg/L respectively,which was significantly higher than (21.49 ± 7.63) g/L,2.61 mg/L,68.0 mg/L in the control group (P ＜ 0.05).Lp-PLA2 and LDL in the observation group were closely related,and associated with the count of coronary artery disease.Two D-dimer and hs-CRP were also related,which were associated with the degree of cardiac function.Conclusion Lp-PLA2 is closely related to lipid metabolism and the main LDL and the severity of coronary artery lesions.hs-CRP is closely associated with the level of two D-dimer and markers of myocardial injury,which indicates that inflammation contribute to myocardial injury and thrombosis.Reduction of heart function may upregulates two D-dimer level to induce thrombosis.Therefore,the prognosis of patients with coronary heart disease can be predicted by Lp-PLA2,hs-CRP and D-two dimer level indicators.