The Significance Of Serum Concentration Of Myeloperoxida-Se Paraoxonase In The Lesion Of Coronary Artery

Objective:Atherosclerotic plaque rupture and accompanying thrombosis are the main pathological basis of acute coronary syndrome (ACS) which related to inflammatory response.This study is to explore the clinical significance of inflammat-ory factor in coronary heart disease (CHD) by detecting serum pro-inflammatory factor myeloperoxidase(MPO) and anti-inflammatory factor paraoxonase(PON) compared with the high-sensitive C-reactive protein.In addition we made further study on the interrelation between anti-inflammatory factors and the pro-inflammatory factors in CHD patients.Methods:300 patients were included in our study according to selective coronary angiography,240 cases were diagnosed as CHD and the other 60 cases served as the control group, CHD were divided into groups of ACS group(n=180) and stable angina (SAP)group(n=60)according clinical diagnosis.CHD group were divided into A-type lesions, B-type lesions, and C-type lesions according to the 1988 ACC/AHA coronary artery disease classification criteria. Quantitative assessment were given by Gensini score standards based on the degree of of coronary artery disease. We used enzyme-linked Immunosorbent Assay (ELISA) method to detect the serum concentration of PON,hs-CRP and used colorimetric to detect activity of MPO.Results:1.CHD group compared with control group:Serum MPO, hs-CRP levels increased significantly, it has shown obvious statistical significance. (P<0.01),while serum PON levels were significantly lower, it has shown obvious statistical significance. (P<0.05).2.ACS group and SAP group:Serum MPO hs-CRP levels increased significantly, it has shown obvious statistical significance. (P<0.01),while serum PON levels were very lower, it has shown obvious statistical significance. (P＜0.05).3.With the increase of the lesions extent and the severity of coronary disease, serum MPO, hs-CRP levels increased gradually, A-type lesions B-type lesions> C-type lesions, it has shown obvious statistical significance (P<0.05).4. Multiple stepwise regression analysis of Gensini score and other risk factors showed that Gensini score had positive correlation with MPO,hs-CRP, meanwhile, it had a negative correlation with the PON.5.Correlation analysis showed that serum levels of MPO and hs-CRP had no correlation, while there was a significant negative correlation between the MPO level and PON level.Conclusions:1.Serum inflammatory cytokines are valuable indicators to assess the risk degree of coronary heart disease. High levels of MPO, hs-CRP can deepen the atherosclerosis and coronary artery disease. On the contrary, high levels of PON does good to patients with coronary heart disease and it can reduce the risk of cardiovascular events.2. Comparing to hs-CRP, MPO can be more effective indicator to predict the risk level of ACS patients.3.MPO and PON are risk factors of coronary heart disease.and they affected the conversion of LDL to ox-LDL, which can be the mechanism of plaque's instability. The balance between Pro-inflammatory factor-MPO and anti-inflammatory factor PON may be an important factor to determine the prognosis of coronary heart disease.