| Aim: To investigate the co-relationship between secretory type II phospholipase A2 (sPLA2) and acute coronary disease(ACS), the blood level of inflammation factors including sPLA2, IL-8 and hs-CRP were studied in 110 patients with ACS.Objects and methods1 .objects:This study enrolled the in-patients in cardiovascular department of our hospital from Aug. 2004 to Jun. 2005. Patients were divded into three groups: 89 patients (age 62 ±8 years old, 53 male, 36 femal) were enrolled as normal control group. Among them all of the patients had no cardiac or other disease by asking history, somatoscopy, chemical assay, chest x -ray, EKG, cardiac ultrasonography examination and coronary artery angiography et al. 63 patients (age 64±9 years, 45 male, 18female) were enrolled as stable coronary heart disease (SCHD) group. 110 patients (age 64± 11years, 87 male, 23 female) were enrolled as ACS group. All of the patients were excluded the inflammative and other diseases.2.Methods(l)blood chemical assay: 5ml of radial artery blood was taken from every studied patients or control subjects before coronary artery angiography. After blood samples un-anticoagulated having been immediately centrifuged at 3000rpm for ten minutes, the serum was aliqusted and stored at -20°c until analyzed. Chemical index including HDL-c, LDL-c, hs-CRP et al was detected by Olympus Au 2700 complete auto-analysis instrument.(2)Detection of sPLA2: All the samples were taken as above. The blood level of sPLA2 was detected by the method of ELISA. Operation was strictly according to the directions offered by reagant kit. Firstly, the detected samples, standard preparation, buffer solution and reaction substrate were added to a board with 96 holes successively. Then color-developing agent and termination agent were added respectively after 37°c water bathing for 30 minutes, and hatching for ten minutes. Finally, the data at 405nm wave lengthen were read, and thery were correct in 570 to 590nm wave lengthen.(3)detection of IL-8: All the blood samples were taken as above.The blood level of IL-8 was detected by the method of flow cytometer. After correlative reagant being prepared, the buffer solution, sample, the fluorescence micro-ball coated with antibody and the detection antibody that was marked with biotin all were successively added to the micro-hole board with filter membrane. After being hatched they were sucked and irrigated repeatedly with vaccum tube , then PE coupled strepto-affinity agent was added. After hatch and repeated suction again they were transferred into flow sample tube, and FSC/SSC two-parameter histogram was made in Coulter flow cytometer, after adjusting parameter the micro-ball in sample tube was taken respectively, the correspond mean fluorescence intensity(MFI) was detected. Finaly, standard curve being made and IL-8 concentration was calculated according to FlowCytomix software.(4)calculate of CAS: The posture which could display the lesion most obviously was adopt to valuate the same lesion.The severity of coronary artery stenosis was analysed by compulate quantitative coronary angiography system, consulting Leaman coronary artery integral method to calculate CAS.?statistics analysis: SPSS 10.0 software was used to statistical analyse the data. Measurement data was descript by mean value ± standard deviation( x ± s). t-test was adopt to compare two group data. One-way analysis of variance was adopt to compare between severalgroups, x 2-test was adopt to check enumeration data, and when p<0.05 suggesting have statistics significance.Result(l)Patients characteristics: Among ACS, SCHD and control group the distribution of age, sex, body weight index(BMI), hypertension, diabetes, LDL and HDL have no statistics difference (p>0.05). Leukocyte counts in ACS group were higher than that in normal control group (p<0.05) and SCHD group(p<0.05) respectively, but the comparison between normal control group and SCHD group had no significance of difference(p>0.05).(2)Relationship between ACS and the blood level of sPLA2: The blood level of sPLA2 in ACS group ((71.3 ± 18.07) u /ml ) was both significantly higher than those in SCHD group ((62.63 + 11.92) u /ml) and normal control group ((55.18+11.75)u/ml) (p<0.01). The level in SCHD group was significantly higher than that in normal control group(p<0.01)too.(3) Change of IL-8, hs-CRP in the patients with couonary disease:Level of IL-8 in ACS group ((194.8 +77.84) U/ml) was significantly higher than that in SCHD group ((159.46 + 78.64)pg/ml) or normal control group ((118.77 + 32.19)pg/ml) (p<0.01), and the level of IL-8 in SCHD group was also higher than that in normal control group. Level of hs-CRP had the same change too.(4) Relationship of sPLA2 with IL-8, hs-CRP:IL-8 and hs-CRP both were inflamation intervene factors. Level of sPLA2 was spearman correlation analysed with IL-8 and hs-CRP, the result suggested that sPLA2 had a positive correlation with hs-CRP (r=0.231,p=0.05) and IL-8 (r=0.203,p=0.007), respectively.(5) Factor^ including sPLA2, age, sex, BMI, hypertension, diabetes, smoking to coronary heart disease was Cox regression analysed, the result suggested that the level of sPLA2 was independent risk factor (p=0.001, relative risk degree 1.012)> but in this study hypertension, diabetes and smoking all hadn't apear independent risk factor founction (p>0.05).(6) Relation between sPLA2 with HDL-C and CAS. Through Spearman correlative analysis, it show that Level of sPLA2 had a negtive correlation with HDL-C (r=—0.173,p=0.005), and had positive relation with coronary artery score (r=0.409,p=0.000), respectively, but had no significante correlation with age, BMI or LDL-C.ConclusionThe level of sPLA2 significantly increased in coronary artery disease, particularly in patients with ACS and it not only had a poistive relationship with IL-8, hs-CRP and CAS, but also had relation with the disorder of lipid metablism. The level of sPLA2 was an indepandent risk factor of coronary artery disease. This result suggests that sPLA2 mightbe a mark valuing the prognosis patients with coronary artery disease and severity of coronary artery lesion. |
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