李东演 杨贤慧 阳建 刘爱胜 刘国栋

【摘要】 目的：了解血清脂蛋白相關磷脂酶A2（LP-PLA2）、可溶性CD36（sCD36）、高密度脂蛋白胆固醇（HDL-C）、脂蛋白a[Lp（a）]、超氧化物歧化酶（SOD）及血清铁蛋白（SF）水平在冠心病（CHD）患者中的表达情况，并探讨其与病情严重程度的相关性。方法：选择2019年2月-2020年8月于深圳市龙华区人民医院和深圳市中西医结合医院就诊的106例CHD患者为CHD组，另选取同期80名健康体检者为对照组。比较两组LP-PLA2、sCD36、HDL-C、Lp（a）、SOD及SF水平。比较不同病情严重程度CHD患者上述指标;分析各指标与病情严重程度的相关性;分析上述指标与CHD的关系。结果：CHD组LP-PLA2、sCD36、Lp（a）及SF水平均高于对照组，而HDL-C和SOD水平均低于对照组（P<0.05）。LP-PLA2、sCD36、Lp（a）及SF水平随病情严重程度加重而升高，而HDL-C和SOD水平随病情严重程度加重而降低，差异均有统计学意义（P<0.05）;CHD患者LP-PLA2、sCD36、Lp（a）及SF水平与病情严重程度均呈正相关（P<0.05），而HDL-C和SOD水平与病情严重程度均呈负相关（P<0.05）;多因素logistic回归分析，LP-PLA2、sCD36、Lp（a）及SF水平为CHD独立危险因素，而HDL-C和SOD为保护因素（P<0.05）。结论：CHD患者LP-PLA2、sCD36、Lp（a）及SF水平明显升高，而HDL-C和SOD水平明显降低，且与病情严重程度有关。同时LP-PLA2、sCD36、Lp（a）及SF水平为CHD独立危险因素，而HDL-C和SOD为保护因素。

【关键词】 冠心病 脂蛋白相关磷脂酶A2 可溶性CD36 高密度脂蛋白胆固醇 脂蛋白a 超氧化物歧化酶 血清铁蛋白

Correlation between LP-PLA2， sCD36， HDL-C， Lp（a）， SOD and SF Levels and Severity of Disease in Patients with Coronary Heart Disease/LI Dongyan， YANG Xianhui， YANG Jian， LIU Aisheng， LIU Guodong. //Medical Innovation of China， 2021， 18（28）： 00-005

[Abstract] Objective： To investigate the expressions of serum lipoprotein associated phospholipase A2 （LP-PLA2）， soluble CD36 （sCD36）， high density lipoprotein cholesterol （HDL-C）， lipoprotein a [Lp（a）]， superoxide dismutase （SOD） and serum ferritin （SF） in patients with coronary heart disease （CHD）， and to explore their correlation between the severity of the disease. Method： A total of 106 CHD patients treated in Shenzhen Longhua District People’s Hospital and Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from February 2019 to August 2020 were selected as the CHD group， and 80 healthy subjects in the same period were selected as the control group. The levels of LP-PLA2， sCD36， HDL-C， Lp（a）， SOD and SF were compared between the two groups. The above indexes of CHD patients with different severity of disease were compared. The correlation between each index and the severity of the disease was analyzed. The relationship between the above indexes and CHD was analyzed. Result： The levels of LP-PLA2， sCD36， Lp（a） and SF in CHD group were higher than those in control group， while the levels of HDL-C and SOD were lower than those in control group （P<0.05）. The levels of LP-PLA2， sCD36， Lp（a） and SF increased with the severity of the disease， while the levels of HDL-C and SOD decreased with the severity of the disease， the differences were statistically significant （P<0.05）. The levels of

LP-PLA2， sCD36， Lp（a） and SF were positively correlated with the severity of CHD （P<0.05）， while HDL-C and SOD were negatively correlated with the severity of CHD （P<0.05）. logistic regression analysis showed that LP-PLA2， sCD36， Lp（a） and SF levels were independent risk factors for CHD， while HDL-C and SOD levels were protective factors （P<0.05）. Conclusion： The levels of LP-PLA2， sCD36， Lp（a） and SF are significantly increased in CHD patients， while the levels of HDL-C and SOD are significantly decreased， which are related to the severity of disease. The levels of LP-PLA2， sCD36， Lp（a） and SF are independent risk factors for CHD， while HDL-C and SOD are protective factors.

[Key words] Coronary heart disease Lipoprotein-related phospholipase A2 Soluble CD36 High density lipoprotein cholesterol Lipoprotein a Superoxide dismutase Serum ferritin

First-author’s address： Shenzhen Longhua District People’s Hospital， Shenzhen 518109， China

doi：10.3969/j.issn.1674-4985.2021.28.001

冠心病（coronary heart disease，CHD）指冠状动脉发生粥样硬化，使血管腔狭窄或闭塞，导致心肌缺血、缺氧甚至坏死而引起的一种心脏病，主要由机体内脂质代谢异常所致的，但近年来，随着对CHD不断深入研究发现，慢性炎症在其发病进程中发挥了重要的作用[1-2]。脂蛋白相关凝脂酶（lipoprotein associated phospholipase A2，LP-PLA2）是一种新型特异性炎症介质，在动脉粥样硬化的发生发展过程中起到重要作用[3]。……