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急性冠脉综合征患者罪犯冠状动脉中溶血磷脂酸水平升高。

Increased lysophosphatidic acid levels in culprit coronary arteries of patients with acute coronary syndrome.

机构信息

Department of Cardiovascular Medicine, Juntendo University School of Medicine, Japan.

出版信息

Atherosclerosis. 2013 Jul;229(1):192-7. doi: 10.1016/j.atherosclerosis.2013.03.038. Epub 2013 Apr 22.

Abstract

BACKGROUND

Lysophosphatidic acid (LPA) is a platelet activator and highly thrombogenic lipid constituent of atherosclerotic plaque. However, whether or not LPA locally released from culprit lesions is associated with acute coronary syndrome (ACS) remains unclear.

METHODS

We studied 52 patients with ACS who were treated by emergency percutaneous coronary intervention and thrombectomy. Levels of LPA and other established biomarkers were enzymatically assayed in samples of culprit coronary arterial and systemic peripheral arterial blood. Levels of LPA and lysophosphatidylcholine (LPC) were measured in plasma, and those of autotaxin, soluble CD40 ligand (sCD40L), hs-CRP and Lp-PLA2 were measured in serum.

RESULTS

Median LPA levels were significantly higher in coronary (CB) than in peripheral (PB) arterial blood (p = 0.009). Levels of sCD40L were higher in CB than in PB, but the difference did not reach statistical significance (p = 0.177). In contrast, autotaxin and Lp-PLA2 levels were significantly higher in PB than in CB (p = 0.005 and p = 0.038, respectively). Levels of LPC and hs-CRP were also higher in PB than in CB (p = 0.129 and p = 0.121, respectively). Levels of LPA in both CB and PB were positively and significantly associated with those of LPC (r = 0.632, p < 0.01 and r = 0.465, p < 0.001).

CONCLUSIONS

Culprit coronary arteries of ACS contained significantly more LPA than the systemic arterial circulation. Higher LPA concentrations might be associated with the pathophysiology of ACS.

摘要

背景

溶血磷脂酸(LPA)是血小板激活剂和动脉粥样硬化斑块中高度促血栓形成的脂质成分。然而,从罪犯病变局部释放的 LPA 是否与急性冠脉综合征(ACS)有关尚不清楚。

方法

我们研究了 52 名接受紧急经皮冠状动脉介入治疗和血栓切除术的 ACS 患者。在罪犯冠状动脉和全身外周动脉血样本中通过酶法测定 LPA 和其他已建立的生物标志物的水平。在血浆中测定 LPA 和溶血磷脂酰胆碱(LPC)的水平,在血清中测定自分泌酶(autotaxin)、可溶性 CD40 配体(sCD40L)、hs-CRP 和脂蛋白相关磷脂酶 A2(Lp-PLA2)的水平。

结果

冠状动脉(CB)血中的 LPA 水平明显高于外周动脉(PB)血(p = 0.009)。CB 中的 sCD40L 水平高于 PB,但差异无统计学意义(p = 0.177)。相比之下,自分泌酶和 Lp-PLA2 水平在 PB 中明显高于 CB(p = 0.005 和 p = 0.038)。LPC 和 hs-CRP 的水平在 PB 中也高于 CB(p = 0.129 和 p = 0.121)。CB 和 PB 中的 LPA 水平与 LPC 水平呈正相关(r = 0.632,p < 0.01 和 r = 0.465,p < 0.001)。

结论

ACS 的罪犯冠状动脉含有明显高于全身动脉循环的 LPA。较高的 LPA 浓度可能与 ACS 的病理生理学有关。

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