Ameliushkina V A, Urazalina S Zh, Kotkina T I, Kaba S I, Titov V N
Klin Lab Diagn. 2012 Mar(3):4-10.
The clinical and pathomorphologic data demonstrate that the most frequent cause of cardiac infarction is the formation of "soft" atheromatosis plaques in the intima of arteries. Their rupture results in thrombosis of coronary arteries. The plaques are characterized by higher content of triglycerides. On the basis of the research data, it is possible to validly consider that the detection of secretary phospholipase content A2 conjugated with lipoproteins is the test of systemic inflammatory response. This response is formed under atherosclerosis in vivo as a feedback to the accumulation in the intercellular medium of the endogenic flogogens (initiators of biological reaction of inflammation)--lipoproteins of lower density subclass A. Their utilization in the intima, as a pool of local interstitial tissue, by the resident macrophagocytes transformed from monocytes result in the formation of doth soft and disposed to laceration atheromatosis plaques and the atherothrombosis of coronary arteries and rarer of carotids. Concurrently, the increase of lipoproteins content in blood plasma is supposed to be the test of proliferation of cells in vivo, the smooth muscle cells of medium in particular. The simultaneous detection of content of secretory associated with lipoproteins phospholipase A2 and lipoprotein (a) can be considered as a valid risk factor of atherosclerosis and atherothrombosis--atheromatosis of intima of arteries with the formation of "soft" plaques in the intima, their laceration and thrombosis of coronary arteries and clinical presentation of cardiac infarction. The diagnostic triad of formation of soft plaques in the intima can be composed of the higher level of triglycerides, the content of protein of phospholipase A2 and lipoprotein (a).
临床和病理形态学数据表明，心脏梗死最常见的原因是动脉内膜中“软”动脉粥样硬化斑块的形成。这些斑块破裂会导致冠状动脉血栓形成。这些斑块的特点是甘油三酯含量较高。根据研究数据，可以合理地认为，检测与脂蛋白结合的分泌型磷脂酶A2含量是全身性炎症反应的检测指标。这种反应在体内动脉粥样硬化形成过程中作为对细胞间介质中内源性致炎因子（炎症生物反应的启动子）——低密度亚类A脂蛋白积累的反馈而形成。单核细胞转化而来的驻留巨噬细胞将其在内膜中作为局部间质组织的一个池加以利用，导致形成柔软且易于撕裂的动脉粥样硬化斑块以及冠状动脉和较少见的颈动脉的动脉粥样硬化血栓形成。同时，血浆中脂蛋白含量的增加被认为是体内细胞增殖的检测指标，特别是中膜平滑肌细胞的增殖。同时检测与脂蛋白相关的分泌型磷脂酶A2和脂蛋白(a)的含量，可被视为动脉粥样硬化和动脉粥样硬化血栓形成的有效危险因素——动脉内膜形成“软”斑块的动脉粥样硬化，斑块撕裂、冠状动脉血栓形成以及心脏梗死的临床表现。内膜中软斑块形成的诊断三联征可由较高水平的甘油三酯、磷脂酶A2蛋白含量和脂蛋白(a)组成。
