| Coronary heart disease (CHD) is the most common cardiovascular disease in theelderly. Often accompanied by acute unstable angina Pectoris, myocardial infarctionor sudden death in patients with acute coronary syndrome (ACS).Therefore, CHD isa great deal of common diseases to hazard the elderly life and health.Current studieshave shown, the occurrence and development of CHD is closely related to theinflammatory response. Therefore, to detect and assess the cardiovascularbiomarkers has become the focus of the modern health and hygiene issues.Recent studies have found that hs-CRP is not only a marker and a predictedmolecular of inflammation.There may be directly involved in the formation ofatherosclerosis.A wide range of atherosclerotic plaque ruptured in coronaryartery,that resulted in the formation of intravascular inflammatory factor.Elevatedlevels of hs-CRP suggest that the instability of coronary artery plaque.Therefore,early detection of plasma hs-CRP level may discover the lesion degree of coronaryartery in order to better diagnosis and treatment.Acute coronary syndrome is mainly characterized by the rupture of lipid-richvulnerable atherosclerotic plaque with subsequent thrombus formation.The Lipid inatherosclerotic plaque was mainly oxidized low density lipoprotein. Its activeingredient is mainly lysophosphatidic acid.LPA is the intermediate product ofphospholipid metabolism,and it is a component of the cell membrance.LPA has theimportant biological function to participate in developing the process of many kindsof cardiovascular diseases.AP and LPA are important lipid signaling molecules insignal transduction of extracellular and intracellular.They mainly produced byphospholipase D and phospholipase C.And AP can be hydrolyzed into LPA in catalysis of phospholipase A2. The LPA system is expected to become a new targetfor the prophylaxis and treatment of CHD and arteriosclerosis.Rencent studises have found,hs-CRP is not only a marker and a predictedmolecular of the inflammation.There may be directly involved in the formation ofatherosclerosis.The rupture of atherosclerotic plaque in coronary artery wouldresulted in intravascular inflammatory factor.The elevated level of hs-CRP suggestthat the instability of coronary artey plaque. Consequently,early detection of thelevel of plasma hs-CRP may discover the lesion degree of coronary artery and makefor better diagnosis and treatment.The study of Jin peiyin et al. found that,the higher level of the plasma LPA inpatients with coronary heart disease reflects the stability of plaque.It has certainclinical significance for the guidance of coronary heart disease and for the riskassessment of patients with coronary heart disease.Correlation analysis showed thatthe level of the plasma LPA in patients with coronary heart disease is proportionateto the Gensini score of coronary artery.It pointed out that the level of LPA is relatedwith the stenosis degree of coronary artery.Serum high sensitivity C-reactive protein (hs-CRP),plasma Lysophosphatidicacid (LPA), is an important indicator for evaluation of CHD harmful levels.Theirpredictive value for ACS has attracted attention by people.Corresponding,they alsoprovide a potential target for intervention atherosclerosis.ObjectivesBy detecting the level of hs-CRP and LPA in the blood of patients with ACS andnormal control group,we will explore their relationship with the severity of coronaryheart disease, and to provide a theoretical basis for clinical intervention.Methods90cases of coronary heart disease who were taken in hospitalized elderlypatients incardiovascular medicine of Taian Central Hospital from April2012toOctober2012were analyzed retrospectively.According to the history, clinicalpresentation, electrocardiogram, cardiac enzymes, troponin, and coronaryangiography examination and other tests,the patients were divided into two groups:the ACS group (58cases) and control group (CG group,32cases) that is not typicalchest pain and normal coronary angiography,as the research object,and comparativeanalysis the difference of LPA/AP with hs-CRP and its relevance amonggroups.Serum hs-CRP concentration was measured by enzyme-linked immunosorbent assay (ELISA).Purified colorimetric determination the plasmaconcentration of LPA.We evaluated the severity of coronary artery lesions by usingGensini score systems.Results1.We collected90cases.Among the58cases of elderly patients with ACS,43cases of male,15cases of female, male to female ratio was (2.87:1).At the age of60-85, averaged (67.58±6.45) years old,there is no significant difference in genderand age(P>0.05).2.A comparative study between different groups of elderly ACS patients:Themost common cause for the tired of25cases (43.1%),followed by the emotion of19cases (32.76%),4cases of unknown causes (6.90%); the region of pain is seen mostfrequently in retrosternal in26cases (44.83%), followed by the area before the heartin22cases (37.93%),and with his left arm pain in6cases (10.34%), throatdiscomfort in5cases (8.62%),2cases (3.44%) toothache;The nature of pain:themost common kind of acupuncturein in12cases (20.69%), secret anguish in11cases(18.97%), no obvious pain in6cases (10.34%);Clinical manifestations of chest painis the most common, there were47cases (81.03%), followed by chest pain in36cases (62.07%);After a rest pain can be relieved in23cases (39.66%), no obviousremission in16cases (27.59%).3.And with the severity of disease, the level of LVEF in ACS group wassignificantly lower than the control group (P<0.05).4.In three groups of patients, the levels of LPA in multi-vessel group (11.28±6.84) compared with the single vessel lesion group (6.73±3.60) and the double vessellesion group (7.17±1.89), the difference was statistically significant(P<0.05).5.In three groups of patients, the levels of AP in multi-vessel group (526.80±298.04) compared with the single vessel lesion group (241.37±191.80) and thedouble vessel lesion group (184.49±123.46),the difference was statisticallysignificant(P<0.05).6.The linear correlation analysis in elderly patients with ACS showedthat:There was a significant positive correlation of the level of the plasma LPA andGensini score (r=0.8148, P<0.0001);There was a significant positive correlation ofthe level of the plasma AP and Gensini score (r=0.8644, P<0.0001); the serumhs-CRP and Gensini score, LPA, AP is not significant correlation (r=0.1374,P=0.1965). Conclusions1.The study found that, elderly patients with ACS were predominantly male, thecommon clinical manifestations is chest pain, chest tightness, palpitation, shortnessof breath, blood pressure, anxiety expression.2.The levels of blood hs-CRP, LPA/AP in elderly patients with ACS weresignificantly higher than those in normal control group.3.The coronary angiography in elderly patients with ACS showed multiplebranch lesions group was significantly higher than that of single vessel lesion groupand double branch lesion group,it suggested the more coronary lesion vessels inelderly patients with ACS, the more coronary lesions severity.4.The levels of hs-CRP and LPA/AP in the blood of elderly patients with ACSmay reflect the degree of coronary artery disease.5.The coronary angiography in elderly patients with ACS showed Gensini scoreincreased, LPA/AP levels were also increased, suggesting that the increased levels ofLPA/AP were related with the degree of coronary artery stenosis.6.The elevated levels of LPA/AP in elderly patients with ACS may trigger theinflammatory response.7.Clinical manifestations in elderly patients with ACS are not typical orasymptomatic, the key to treatment is rapid and accurate diagnosis. This study foundthat the levels of LPA/AP were associated with the severity of coronary arterydisease.With the further research, we expect that the index can be molecular biologymarkers to diagnosis in elderly patients with ACS. |
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