| Objective:By studying the changes of Lp-PLA2concentration in plasma in patients withcoronary heart disease to investigate the correlation between Lp-PLA2and leftcardiac function and AS.To assessment the effect of valsartan therapy and theinfluence of Lp-PLA2level and cardiac function on patients.Methods:117patients who have accepted coronary angiography (CAG) in FujianProvincial Hospital Cardiovascular Medicine,all of the patients did not acceptlipoprotein treatment.According to the results of CAG,the typical clinicalmanifestations,the electrocardiogram,serum creatine kinase,cTnI and so on,thepatients were divided into coronary heart disease group [including30patients in acutemyocardial infarction group(AMI group),32patients in unstable angina group(UAP group),28patients in stable angina pectoris group(SAP group)] and27patientsin control group.Coronary heart disease group was divided into two groups:in45patients taking valsartan eight weeks or more for valsartan group,eight weeks withoutany application Ⅱ angiotensin receptor antagonist and angiotensin converting enzyme inhibitor is45cases of non-valsartan groups.Collecting5ml peripheral blood fromeach admissed patient in the fasting next morning,then separating plasma;Ultrasoniccardiogram measurement of left ventricular ejection fraction and indicators (coronaryheart disease group of eight weeks after extraction,the method again with theformer).Collecting the physical datas of all the patients.According the CAG statiscingthe numbers of coronary artery lesions and quantitatively assessing the degree ofcoronary artery stenosis by Gensini scoring system.Using enzyme-linkedimmunosorbent assay (ELISA) to measure the Lp-PLA2in plasma.Using GE Vivid-7Demision ultrasonic diagnostic instrument measurement indicators in patients withcardiac function.Result:1.Gender,age,smoking history,hypertension history,SBP,DBP,FBS,TC and TGamong the AMI group,UAP group,SAP group,control group show no significantdifference (P＞0.05).LDL-C in AMI group and UAP group are higher than the controlgroup(P＜0.05),between SAP group and control group show no significant difference(P＞0.05).HDL-C in AMI group and UAP group are less than control group(P＜0.05),there are no significant difference between SAP group and control group (P＞0.05).Hs-CRP in AMI group and UAP group is higher SAP group(P＜0.05)andcontrol group(P＜0.01),there are no significant difference between SAP group andcontrol group (P＞0.05).2.The Lp-PLA2in each subgroup of CHD(AMI group,UAP group,SAPgroup)are higher than control group(P＜0.01),LVEF in each subgroup of CHD arelower than control group (P＜0.01);Lp-PLA2、LVEF compared between two groupsalso have statistical significance (P＜0.01).3.The numbers of coronary artery lesions and Gensini scores of coronary arteryamong each subgroup of CHD show no significant difference (P＞0.05).4.The level of Lp-PLA2in plasma is a significantly negatively correlated withLVEF、HDL-C (r=-0.693,P＜0.001; r=-0.324,P＜0.001),a significant positivecorrelated with LVEDV、LVESV、LDL-C、hs-CRP (r=0.509,P＜0.001;r=0.658, P ＜0.001;r=0.267,P＜0.001;r=0.527,P＜0.001),no correlated with Gensini scores ofcoronary artery.5.After treatment the Lp-PLA2level、LVESV、LVEDV of Coronary heartdisease group were reduced significantly,the LVEF was significantly rised,thedifference has statistically significant (P＜0.01);after treatment,Lp-PLA2level,LVESV、LVEDV of the Valsartan group were significantly lower than the Non-Valsartan group,the LVEF of the Valsartan group was significantly higher than theNon-Valsartan group.Conclusion:1.The level of Lp-PLA2is correlation to the stability of coronary arteryatherosclerotic plaque,it plays an important role in the appearance and developmentprocess of AS.It may be a new clinical therapeutic target for AS.2.The level of Lp-PLA2in plasma and cardiac function index have obviouscorrelation,it may be useful as a guide in coronary artery disease of diagnosis.3.Using Valsartan to treat the coronary heart disease,it can significantly reducesymptoms and improve cardiac function.4. Valsartan may have anti-inflammatory effects,the Lp-PLA2help judgecurative effect in patients with CHD. |
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