| Objective:To investigate the changes of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and its clinical significance in patients with coronary heart diseases(CHD),and explore the relationship between it and high sensitive C-reactive protein, interleukin-18, White blood(cell) count and other inflammatory factors of CHD.Method:All 176 hospitalized patients who were suspected as coronary heart disease according to the results of coronary angiography(CAG) in August 2008-October 2009 were divided into two groups:CHD group (cases n=146) and non-CHD group (controls n=30). The patients of the CHD group were further divided into subgroups according to the clinical types. The 146 CHD patients cinsisted of 38 SAP patients,56 UAP patients and 52 AMI patients.Blood samples were taken to measure serum Lp-PLA2 density before coronary angiography and therapy while the levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-c), high density lipoprotein-cholesterol(HDL-c),apolipoproteinA1(ApoA1),apolipoproteinB(ApoB), lipoprotein(a)(Lp(a)),high-sensitivity C-reactive protein(hs-CRP), interleukin-18(IL-18), white blood(cell) count(WBC), fibrinogen(Fbg) and glucose(Glu) were measured in all subjects. And serum levels of Lp-PLA2 of clinical subgroups of coronary heart disease were compared with healthy control group.The correlations of Lp-PLA2 density with hs-CRP,IL-18,WBC and other inflammatory makers and general clinical data were analysed.Result:(1) Lp-PLA2 density was significantly higher in SAP,UAP,AMI of CHD than those of healthy control group and the difference was statistically significant(63.86±10.45mg/ml VS 47.22±8.73 mg/ml;69.52±9.83 mg/ml VS 47.22±8.73 mg/ml;72.14±9.51 mg/ml VS 47.22±8.73mg/ml P<0.01). And serum Lp-PLA2 density of AMI group and UAP showed no difference(72.14±9.51mg/ml VS 69.32±9.83 mg/ml P>0.05), but were higher than SAP group. (2) By the correlation analysis of two variables in the whole population, serum Lp-PLA2 levels was positively correlated with inflammatory markers IL-18,WBC levels(r=0.735, P<0.001; r=0.265,P<0.001)while it was no correlation with hs-CRP and Fbg(r=0.032,P>0.05; r=0.086, P>0.05).Serum Lp-PLA2 levels in UAP and AMI groups was positively correlated with and inflammatory markers IL-18(r=0.646,P<0.001;r=0.842,P<0.01),WBC(r=0.286,P<0.05;r=0.322, P<0.05)levels while it was no correlation with IL-18, WBC in control and SAP.(3) By the correlation analysis of two variables in the whole population, serum Lp-PLA2 levels was positively correlated with TC (r=0.211, P<0.01), LDL-c (r=0.435, P<0.001), Lp(a) (r=0.246, P<0.001),ApoB(r=0.523,P<0.001),while it was not significantly correlated with TG,HDL-c, ApoA1,Age,BMI,Glu,SBP,DBP and UA.(4) Non-conditional Logistic regression analysis showed that the OR value for CHD associated with increasing Lp-PLA2 density was10.78(95%CI=1.74-66.92,P<0.01),the odds ratio for smoking, hypertension, diabetes and LDL-c respectively was 1.23(95%CI=1.08-1.52,P<0.01),6.84(95%CI=2.18-21.40,P=0.01),2.60(95%CI=1.02-6.63, P<0.05),1.37(95%CI=1.11～1.71,P<0.01).Conclusion:(1) The serum levels of Lp-PLA2 density can reflect the activities of coronary artery disease. And the condition of coronary heart disease can be judged from it in a certain value. (2) Lp-PLA2 can join in inflammatory reaction of coronary atherosclerosis in coordination with the other inflammatory factors, promote processes present at every stage of CHD. Lp-PLA2 is a new inflammatory maker of CHD.(3) The levels of serum Lp-PLA2 was correlated with TC, LDL-c, Lp(a) and ApoB, while it was not correlated with TQHDL-c, ApoAl, Age, BMI, Glu,SBP, DBP and UA. (4) Plasma Lp-PLA2 was a cardiovascular risk factor independently of other risk factors, and the ELISA method of quantitative measurement of their density can help to predict the risk of coronary heart disease. Lp-PLA2 may provide a new target for the treatment of CHD. |
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