Yang Eric H, McConnell Joseph P, Lennon Ryan J, Barsness Gregory W, Pumper Geralyn, Hartman Stacy J, Rihal Charanjit S, Lerman Lilach O, Lerman Amir
Division of Cardiovascular Diseases, Mayo College of Medicine, Rochester, MN 55905, USA.
Arterioscler Thromb Vasc Biol. 2006 Jan;26(1):106-11. doi: 10.1161/01.ATV.0000191655.87296.ab. Epub 2005 Oct 20.
The purpose of the current study was to determine whether lipoprotein-associated phospholipase A2 (Lp-PLA2) is associated with coronary endothelial dysfunction and is a predictor of endothelial dysfunction in humans.
Patients (172) with no significant coronary artery disease (<30% stenosis) undergoing assessment of coronary endothelial function were studied. Endothelial function was assessed by the change in coronary blood flow and coronary artery diameter in response to intracoronary acetylcholine. Plasma concentrations of Lp-PLA2 were measured, and patients were divided into tertiles. Patients in tertiles 2 and 3 had a significantly lower change in coronary blood flow (63.8+/-73.2 and 32.0+/-71.7 versus 78.4+/-73.2%; P<0.001) and greater epicardial coronary artery vasoconstriction (-14.1+/-14.7 and -23.3+/-25.1 versus -9.5+/-15.2% mean diameter change; P<0.001) in response to acetylcholine. Patients with coronary endothelial dysfunction had significantly higher serum concentrations of Lp-PLA2 than those with normal endothelial function (246.2+/-71.6 versus 209+/-56.7 ng/mL; P=0.001). The odds ratio for coronary endothelial dysfunction in patients with Lp-PLA2 in the highest tertile was 3.3 (95% CI, 1.6 to 6.6).
Lp-PLA2 is independently associated with coronary artery endothelial dysfunction and is a strong predictor of endothelial dysfunction in humans.
本研究旨在确定脂蛋白相关磷脂酶A2（Lp-PLA2）是否与冠状动脉内皮功能障碍相关，以及是否可作为人类内皮功能障碍的预测指标。
对172例无明显冠状动脉疾病（狭窄<30%）且正在接受冠状动脉内皮功能评估的患者进行了研究。通过冠状动脉内注射乙酰胆碱后冠状动脉血流和冠状动脉直径的变化来评估内皮功能。测定血浆Lp-PLA2浓度，并将患者分为三分位数组。三分位数组2和3的患者在注射乙酰胆碱后冠状动脉血流变化显著更低（分别为63.8±73.2和32.0±71.7，而78.4±73.2%；P<0.001），且心外膜冠状动脉血管收缩更明显（平均直径变化分别为-14.1±14.7和-23.3±25.1，而-9.5±15.2%；P<0.001）。冠状动脉内皮功能障碍患者的血清Lp-PLA2浓度显著高于内皮功能正常的患者（分别为246.2±71.6和209±56.7 ng/mL；P=0.001）。Lp-PLA2处于最高三分位数组的患者发生冠状动脉内皮功能障碍的比值比为3.3（95%可信区间，1.6至6.6）。
Lp-PLA2与冠状动脉内皮功能障碍独立相关，且是人类内皮功能障碍的有力预测指标。
