摘要
Abstract
Objective To explore the changes of serum lipoprotein phospholipase A2(Lp_PLA2) and its correlation to major adverse cardiac events(MACE)in acute coronary syndrome(ACS) patients with percutaneous coronary intervention (PCI)during perioperative period. Methods 102 patients with ACS were selected ,and divided into three groups ,as unstable angina pectoris (UAP group) with 40 cases ,ST elevation myocardial infarction (STEMI group) with 26 cases ,non ST elevation myocardial infarction (NSTEMI group) with 36cases. According to the Gensini score ,they were divided into mild group (Gensiniscore ≤ 20points) with 24 cases ,moderate group (20 points < Gensini score ≤ 40 points) with 46 cases ,severe group (Gensini score > 40)with 32 cases .60 patients without coronary heart disease at the same period were included to be the control group. Preoperative ,intraoperative and postoperative Lp_PLA2 levels were measured and their correlation to MACE were analysed. Results (1)Before PCI ,the level of Lp_PLA2 in ACS pa-tients was higher than that in control group (P< 0.05) ,and the level in NSTEMI group was higher than that in UAP group ( P <0.05). In ACS patients ,the level of Lp_PLA2 after PCI ,was lower than that before PCI (all P< 0.05) ,but there was no significant difference in Lp_PLA2 between the UAP ,STEMI and NSTEMI groups after PCI (P> 0.05). (2)Before PCI ,the level of Lp_PLA2 in moderate and severe ACS patients were higher than that in mild group (P< 0.05) ;After PCI ,the level of Lp_PLA2 in the three groups were significantly lower than that before PCI (P< 0.05) ,and the level of Lp_PLA2 in moderate group and severe group were higher than that in mild group (P< 0.05). (3)The Gensini score of STEMI group was higher than that of UAP group (P< 0.05) ;The Gensini score of patients in severe ACS was higher than that of mild group (P< 0.05). (4)There was a significant statistically difference in the incidence of MACE among different types of ACS patients (P< 0.05) ;There was a significant statistically difference in the incidence of MACE among ACS patients with different degree of coronary artery disease ( P < 0.05). (5)Preoperative Lp_PLA2 was positively correlated with MACE (r = 0.62 ,P< 0.05) ,and Lp_PLA2△ (preoperative_postoperative) level was negatively correlated with MACE (r = - 0.66 , P < 0.05) ;Lp_PLA2 had no significant correlation with Gensini score ,while Gensini score was positively correlated with MACE (r = 0.45 , P < 0.05).Conclusions The level of Lp_PLA2 in ACS patients was significantly increased ,while it was declined after PCI. There is a positive correlation between Gensini score and MACE.关键词
急性冠状动脉综合征/血清脂蛋白磷脂酶A2/经皮冠状动脉介入治疗/主要不良心脏事件Key words
Acute coronary syndrome/Serum lipoprotein phospholipase A2/Percutaneous coronary intervention/Major adverse cardiac events分类
医药卫生
