何鼎洋 赵新生 黄创杰

[摘要]目的 研究分析脂蛋白相关磷脂酶A2（lipoprotein-associated phospholipase A2，Lp-PLA2）与冠心病患者左心功能的相关性，并探讨厄贝沙坦干预对冠心病患者的作用。方法 选取2016年1月～2018年3月我院收治的116例冠心病患者与我院行健康体检的50例健康志愿者，分别设为冠心病组、对照组，采集其空腹外周静脉血，检测血浆Lp-PLA2表达水平，比较冠心病组与对照组的血浆Lp-PLA2表達水平，并比较两组的左心射血分数。根据左心射血分数将冠心病组患者分为左心功能不全组、左心功能正常组，比较不同左心功能患者的血浆Lp-PLA2表达水平，并分析血浆Lp-PLA2表达水平与冠心病患者左心功能的相关性。针对冠心病患者实施厄贝沙坦药物干预，比较治疗前后患者的左心射血分数、血浆Lp-PLA2表达水平。结果 冠心病组的血浆Lp-PLA2表达水平高于对照组（P<0.05）；冠心病组的左心射血分数低于对照组（P<0.05）；左心功能不全组的血浆Lp-PLA2表达水平高于左心功能正常组（P<0.05），血浆Lp-PLA2表达水平与左心功能呈负相关（r=-0.783， P<0.05）。经厄贝沙坦治疗后，冠心病患者的左心射血分数较治疗前增高（P<0.05），其血浆Lp-PLA2表达水平较治疗前降低（P<0.05）。结论 冠心病患者的血浆Lp-PLA2表达水平普遍上调，血浆Lp-PLA2表达水平可对冠心病患者左心功能予以反映，而经厄贝沙坦干预可有效改善患者左心功能，促使其血浆Lp-PLA2表达水平下调。

[关键词]冠心病；脂蛋白相关磷脂酶A2；左心功能；相关性；厄贝沙坦

[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0072-03

[Abstract] Objective To study the analysis of lipoprotein associated phospholipase A2 （lipoprotein-associated phospholipase A2， Lp-PLA2） and the correlation of left heart function in patients with coronary heart disease （CHD）， and explore he sand and the effect of intervention in patients with coronary heart disease （CHD）. Methods A total of 116 cases of patients with coronary heart disease （CHD） and 50 cases of healthy volunteers with physical examination in the hospital from January 2016 to March 2018 were selected and set to coronary heart disease group and the control group respectively. The level of plasma Lp-PLA2 expression was measured and the level of plasma Lp-PLA2 expression was compared between the coronary heart disease group and the control group， and the left cardiac ejection fraction of the two groups was compared. According to the left cardiac ejection fraction， the patients in the coronary heart disease group were divided into left heart dysfunction group and normal left heart function group. The plasma Lp-PLA2 expression level of patients with different left heart function was compared， and the correlation between plasma Lp-PLA2 expression level and left heart function of patients with coronary heart disease was analyzed. Irbesartan drug intervention was applied to patients with coronary heart disease. The left ventricular ejection fraction and plasma Lp-PLA2 level were compared before and after treatment. Results The expression level of plasma Lp-PLA2 in the CHD group was higher than that in the control group （P<0.05）. The left cardiac ejection fraction in the CHD group was lower than the control group （P<0.05）. The expression level of plasma Lp-PLA2 in the left cardiac dysfunction group was higher than that in the left cardiac function group （P<0.05）， and the expression level of plasma Lp-PLA2 was negatively correlated with the left cardiac function （r=-0.783， P<0.05）. After treatment with irbesartan， the left cardiac ejection fraction of the patients with coronary heart disease was higher than that before treatment （P<0.05）， and the plasma Lp-PLA2 expression level was lower than that before treatment （P<0.05）. Conclusion The level of plasma Lp-PLA2 expression in patients with coronary heart disease is generally up-regulated， and the level of plasma Lp-PLA2 expression can reflect the left heart function of patients with coronary heart disease， and the intervention by irbesartan can effectively improve the left heart function of the patients， and reduce the level of Lp-PLA2 expression in plasma.

[Key words] Coronary heart disease； Lipoprotein associated phospholipase A2； Left ventricular function； Correlation； Irbesartan

冠心病在临床上属于常见病和多发病，患者存在不同程度的心肌缺血狀况，长期以往，容易出现心室重构，导致患者左心功能受损，对其生命安全构成威胁，故需对冠心病左心功能损伤予以及时发现，再予以积极治疗[1-3]。近年来，Lp-PLA2与动脉粥样硬化病变的相关研究越来越多，关于Lp-PLA2在动脉粥样硬化中的作用尚有待证实。本研究选取116例冠心病患者与50例健康体检者进行研究，并针对冠心病患者采用厄贝沙坦干预，旨在探讨Lp-PLA2与冠心病患者左心功能的相关性，现报道如下。……