冠心病患者血浆髓过氧化物酶与高密度脂蛋白胆固醇的关系

摘要

[目的]探讨血浆髓过氧化物酶(MPO)与急性冠脉综合征(ACS)的关系以及影响它们之间关系的因素,以寻找预测ACS的联合标志物.[方法]将本院66例诊断为冠心病的患者研究分为ACS组(36例)、稳定型心绞痛组(SAG,30例).20例冠脉造影正常者为对照组(CG).测定、比较各组研究对象的血浆MPO水平和高密度脂蛋白胆固醇(HDL-C)水平的差异,分析所有研究对象的这两个指标的相关性,同时分析MPO与其它血脂及传统危险因素的关系.[结果]ACS组血浆MPO浓度显著高于SAG组和CG组(P<0.01).SAG痛组与CG组之间差异无显著性(P>0.05).直线相关分析表明血浆MPO与HDL-C显著负相关,与低密度脂蛋白胆固醇(LDL-C)无相关.HDL-C≥1 mmol/L,MPO水平在ACS组和对照组无明显差异(P>0.05).HDL-C＜1 mmol/L时, MPO水平在ACS组和对照组有显著差异(P<0.01).低水平HDL-C组,MPO和HDL-C相关性(r=-0.76,P<0.01)强于高水平组(r=-0.57,P<0.01).MPO与血浆高敏C反应蛋白(hsCRP)弱相关.血浆MPO与传统危险因子(性别,年龄、吸烟史、糖尿病史、高血压史)无相关性.[结论]血浆MPO水平在ACS患者中显著升高.HDL-C的水平影响MPO和冠心病的关系,MPO和HDL-C可作为更好判断ACS的联合生化指标物.%[Objective]To explore the relationship between plasma myeloperosidase(MPO) and acute coronary syndrome(ACS) and their influential factors in order to search the combination biomarkers for predicting ACS.[Methods]Sixty six patients diagnosed as coronary artery disease(CAD) in our hospital were divided into ACS group( n = 36) and stable angina pectoris(SAP) group( n = 30). Twenty patients with normal coronary angiogra phy were enrolled in the control group. Plasma MPO and HDL-C of all subjects in each group were measured and compared. The relationship between MPO and HDL-C was analyzed. The correlation between MPO and other blood lipids, traditional risk factors was also analyzed at the same time. [Results] Plasma MPO level of ACS group was significantly higher than that of both SAP group and normal control group( P ＜0. 0l), and there was no significant difference between SAP group and normal control group (P ＞ 0. 05). Linear correlation analysis showed that MPO was negatively correlated with HDL-C, and not related with LDL C. There was no significant difference in MPO between ACS group and control group( P ＞0. 05) while HDL C≥lmmol/1. There was signifi cant difference in MPO between ACS group and control group( P ＜0. 0l) while HDL-C＜lmmol/L. The correla tion between MPO and HDL-C in low HDL-C group(r = - 0.76, P ＜0.0l) was stronger than that in high HDL- C group(r = - 0. 57, P ＜0. 0l). MPO was slightly related with hsCRP. Plasma MPO was independent of tradi tional risk factors such as sex, age, the history of smoking, diabetes and hypertension. [Conclusion] Plasma MPO level in ACS patients is increased significantly. HDL C level can affect the relationship between MPO and coronary heart disease. MPO and HDL-C can be the combination biomarkers for ACS.