| Objective: 1.To evaluate the correlation between plasma oxidized low density lipoprotein(ox-LDL)level and the degree of coronary artery disease.2.To evaluate the dynamic changes of plasma ox-LDL before and after percutaneous coronary intervention(PCI).3.To establish the reference interval of ox-LDL in our laboratory for the diagnosis,treatment and prognosis of atherosclerosis.Methods: 1.Ninety-nine patients who were underwent coronary angiography in the Second Hospital of Jilin University between September 2017 to June 2018 were recruited and divided into control group(C group,n=30),stable angina pectoris group(SAP group,n=21),unstable angina pectoris group(UAP group,n=21)and acute myocardial infarction group(AMI group,n=27).Ox-LDL,MDA,hs-CRP,LDL-C,HDL-C,apo A,apo B,LP(a)levels in plasma were detected.2.Forty-three patients with acute coronary syndrome(ACS)who underwent coronary angiography(CAG)during August 2017 and May 2018 in the Second Hospital of Jilin University were prospectively recruited.Among them,PCI with stent implantation was performed in 21 patients(PCI-ACS group)and another 22 patients were selected as non-PCI-ACS group.In addition,no stenosis was found in 20 normal healthy patients at the same time by coronary angiography;these patients were included as a control group(non-CHD control group).30 age-and sex-matched patients who underwent general surgery,such as non-incarcerated external hernia repair,non-anemic leiomyoma resection,lumbar disc herniation,and nucleus pulposus extirpation,were selected as the surgical stress control group.Peripheral venous blood was collected before,immediately after and 18 h after surgery in each group and the level of ox-LDL,MDA,TC,LDL,HDL,hs-CRP,Apo A,Apo B,LP(a)were measured.3.145 healthy adults who underwent physical examination in our hospital were prospectively recruited.Fasting peripheral venous blood was collected from every subject and ox-LDL level was measured which was used as the reference interval in our laboratory.Results: 1.The plasma ox-LDL level was significantly higher in patients with CHD than in controls(P<0.001).However,it was lower in the UAP and AMI groups compared to SAP group(P<0.001).Hs-CRP increased with the aggravation of CHD lesions(P<0.001),and there was a significant negative correlation between plasma ox-LDL and hs-CRP(P=0.011).The lipid peroxide level(MDA)was significantly higher in patients with CHD(P<0.001)and increased with the severity of the disease(P<0.001).Serum MDA and hs-CRP presented a significant positive correlation(P=0.004).2.Ox-LDL declined significantly immediately after PCI compared with before in PCI-ACS group(P=0.002).There was no difference in ox-LDL between immediately after and 18 h after PCI(P=0.633).There was no significant differences in the time-dependent changes of ox-LDL in the non-PCI-ACS group and non-CHD control group(P=0.171,P=0.579,respectively).In the surgical stress control group,time changes of ox-LDL concentrations showed the same pattern as the PCI-ACS group,namely being maximal on admission,decreasing immediately after surgery(P=0.005),and still remaining the low level after 18 h compared to immediately(P=0.113).3.MDA of the PCI-ACS group significantly increased immediately after PCI(P<0.001)while MDA decreased after 18 h(P=0.002)compared with immediately after PCI.However,there was no significant difference in MDA level between admission and immediately after CAG in the non-PCI-CHD group(P=0.372),but MDA significantly declined after 18 h compared with before(P<0.001).Serum MDA levels continued to rise over time in the non-CHD control group(P<0.001).There was no significant difference at various points during the operation in the surgical control group(P=0.218).4.Plasma ox-LDL were detected in 145 healthy adults,including 73 males and 72 females.The average ages were 41.20±11.1 years old.The ox-LDL reference interval of normal adults was [35.57-134.32]U/L.Conclusions: 1.Plasma ox-LDL can be used as a biomarker for stable coronary angina.2.Both PCI and surgical stress may not result in immediate elevation in plasma Ox-LDL level.The body can clear and maintain homeostasis of the internal environment through the reticular endothelial system or other mechanisms.3.The reference interval of ox-LDL for normal adults in our laboratory was [35.57-134.32]U/L. |
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