| Background and purpose Coronary heart disease is an important problem that China,even the world is tacing.The mortality rate and disability rate of it are extremely high,and the cost of treatment has become an immense burden for society.The current advanced medical measures cannot obviously prevent the rising state of coronary heart disease.It is presumed that the reason is related to the lack of preventive measures.In the diagnosis of coronary heart disease,invasive and high-risk operations are often required,although the diagnosis rate and the cost is high,which made many patients have lost the opportunity for examination.A new predictor of coronary heart disease,lipoprotein-associated phospholipase A2(Lp-PLA2),has been recognized as an indicator of severe coronary artery disease,and is used for clinical screening of healthy people and stable follow-up of patients with coronary heart disease.The purpose of this experiment is to explore the level of Lp-PLA2 in patients with different degrees of coronary stenosis,as well as the relationship between Lp-PLA2 and other inflammatory indicators and blood lipids,in order to provide more experimental basis for clinical application.Methods The patients who were admitted to the Department of Cardiovascular Medicine of the First Affiliated Hospital of Anhui Medical University(January 2017-December 2018)and underwent coronary angiography were selected as the research objects,and 126 patients with confirmed CHD were selected as the experimental group.In the same period,44 non-CHD patients were selected as the control group,who were excluded by coronary angiography,clinical symptoms,and experimental indicators).The experimental group was divided into three groups by three different methods:(1)According to Gensini scores of patients’ radiographic results:experiment group were divided into low-risk group(n <20),intermediate-risk group(20≤n <40),and high-risk group(n≥40);(2)According to clinical symptoms,medical history and biochemical indicators: they were divided into stable angina(SAP)group,unstable angina(UAP)group and acute myocardial infarction(AMI)group.(3)According to the number of patients’ diseased branches which has vascular stenosis ≥50%,they were divided into single-vessel disease group,double-vessel disease group and three-vessel disease group.Collect clinical information and biochemical indicators of all subjects,and detect serum Lp-PLA2 levels.Results:In the Gensini score,there was no difference in serum Lp-PLA2 levels between the low-risk group and the intermediate-risk group(p> 0.05),and there was difference between the high-risk group and the low-risk and intermediate-risk groups(p<0.05);There was difference in serum Lp-PLA2 levels between the two-vessel lesion group and the three-vessel lesion group compared with the single-vessel lesion \ group(p<0.05),and there was no difference between the two-vessel and three-vessel lesion groups(p> 0.05).Serum Lp-PLA2 levels were significantly different from the SAP group(p <0.05),and there were significant differences between the UAP group and the AMI group(p <0.05).Perason correlation analysis showed that the serum level of Lp-PLA2 was positively correlated with Total cholesterol(TC),Low density lipoprotein(LDL),and Gensini scores.Univariate regression analysis suggested that n-HDL(Z = 2.39,p <0.01)and Lp-PLA2(Z = 3.17,p <0.01)were risk factors for CHD,and High density lipoprotein(HDL)(Z = 1.97,p <0.01)was the protective factor of CHD.Conclusions:1.Serum Lp-PLA2 levels can increase with the severity of coronary stenosis,which suggests that Lp-PLA2 can reflect the severity of coronary lesions.2.Serum Lp-PLA2 levels are positively correlated with TC,LDL,and Gensini scores,which suggests that early detection of Lp-PLA2 can help confirmed the diagnosis of early-stage CHD patients.3.Serum Lp-PLA2 is associated with the onset of coronary heart disease and is an independent risk factor for CHD.Reducing Lp-PLA2 levels may become a new target for treating CHD. |
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