摘要
目的检测经冠状动脉造影显示为Ⅱ型斑块的冠心病患者血浆中妊娠相关蛋白酶-A(PAPP-A)和丙二醛化低密度脂蛋白(MDA-LDL)水平,从临床角度探讨斑块破裂的原因。方法收集冠脉造影的冠心病患者85例,根据斑块形态,冠心病患者分为三组,即Ⅰ型病变(表面光滑)组(n=31),Ⅱ型病变(表面不规则)组(n=35)及Ⅲ型病变(长段不规则)组(n=19),冠脉造影正常的25例为对照组纳入研究。检测各组血浆PAPP-A、MDA-LDL、LDL、HDL。结果Ⅱ型病变组平均血浆PAPP-A、MDA-LDL显著高于对照组、Ⅰ型病变组、Ⅲ型病变组(P均<0.01)。Ⅱ型病变组血浆MDA-LDL与LDL、HDL无明显相关性(P均>0.05),MDA-LDL与PAPP-A呈中度正相关(r=0.630,P<0.01)。结论冠状动脉造影显示斑块破裂的冠心病患者血浆PAPP-A、MDA-LDL水平明显升高;MDA-LDL与与PAPP-A呈中度正相关,提示氧化应激、炎症反应加强均是导致斑块破裂的原因,且氧化应激可能通过诱导、加剧炎症反应或与炎症因子交互作用发挥其致斑块破裂作用。
Objective To examine plasma levels of pregnancy-associated plasma protein-A （PAPP-A） and malondialdehyde-modified low density lipoprotein （MDA-LDL） in patients with angiography type 11 lesions （representing plaque rupture with or without thrombosis）, and to evaluate the role of PAPP-A and MDA-LDL in the development of plaque disruption. Methods One hundred and ten patients entered in this study. All patients underwent coronary angiography. It included eighty-five patients with coronary heart disease （CHD） and twenty-five controls. The angiographic morphology of plaques was analyzed. According to the morphologic types of plaque, the patients with CHD were divided into type Ⅰ （smooth borders） group （n=31） and type Ⅱ （irregular lesions） group （n=35） and type ~ （long lesions） group （n= 19）. All patients were measured of PAPP-A and MDA-LDL in plasma. Results Plasma PAPP-A and MDA-LDL in type Ⅱ group was significantly higer than that in the controls group, type Ⅰ group, type Ⅲ group （P〈0.01）. The plasma levels of MDA-LDL were not correlation to LDL and HDL in the patients with typeⅡ group （P〉0.05）. The plasma levels of MDA-LDL and PAPP-A had a significant positive correlation in the patients with type Ⅱ group （r=0. 630, P〈0. 01）. Conclusion Plasma levels of PAPP-A and MDA-LDL increased in patients with coronary plaque rupture; MDA-LDL and PAPP-A had a positive correlation, it indicates that the oxidative stress is likely to either induce or intensify inflammatory action, and maybe coeffect of with inflammation facts to cause or accelerate plaque rupture.
出处
《中国医学影像技术》
CSCD
北大核心
2007年第2期226-228,共3页
Chinese Journal of Medical Imaging Technology
