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目的:探讨血清氧化型低密度脂蛋白(ox-LDL)及其自身抗体(ox-LDL Ab)与冠状动脉痉挛(CAS)的关系及调脂治疗对其影响。方法:58例经乙酰胆碱激发试验诊断为CAS患者根据入院时心绞痛的临床特点分为稳定型心绞痛(SAP)组和不稳定型心绞痛(UAP)组,其中SAP26例,UAP32例,并与乙酰胆碱试验阴性的非痉挛患者24例作对照(对照组),在阿司匹林和钙拮抗剂治疗基础上,加用他汀类调脂治疗2周,测定3组患者治疗前后血清ox-LDL、ox-LDLAb、超敏c反应蛋白(hs-CRP)和血脂项目。结果:治疗前血清ox-LDL、ox-LDLAb及hs-CRP水平UAP组>SAP组>对照组(分别P<0.05),各组间血清TG、TC、LDL-C水平差异无统计学意义;SAP组、UAP组ox-LDL及ox-LDL Ab与hs-CRP呈正相关(r=0.438,r=0.385;分别P<0.05),而与TG、TG及LDL-C均无显著相关。治疗后各组TG、TC、LDL-C均轻度下降,但与治疗前比较差异无统计学意义,对照组ox-LDL及ox-LDLAb、hs-CRP无显著下降;而SAP组和UAP组ox-LDL及ox-LDLAb、hs-CRP均显著降低(分别P<0.05),其ox-LDL及ox-LDL Ab与hs-CRP呈正相关(r=0.508,r=0.435;分别P<0.05)。结论:ox-LDL、ox-LDLAb均可以有效反映体内炎症水平,其升高可能与CAS病变不稳定状态有关,短期调脂治疗可以显著地降低其血清ox-LDL和ox-LDLAb水平。
OBJECTIVE: To investigate the relationship between serum ox-LDL and ox-LDL Ab and coronary artery spasm (CAS) and the effect of lipid-lowering therapy. Methods: Fifty-eight CAS patients diagnosed with acetylcholine provocation test were divided into stable angina pectoris (SAP) group and unstable angina pectoris (UAP) group according to the clinical features of admission angina pectoris. Among them, 26 cases were SAP and 32 cases were UAP. (Control group). On the basis of aspirin and calcium antagonist, statins were used for two weeks. Serum levels of ox-LDL, ox-LDLAb and hypersensitivity were measured in three groups before and after treatment c-reactive protein (hs-CRP) and lipids project. Results: Before treatment, serum levels of ox-LDL, ox-LDLAb and hs-CRP in UAP group> SAP group> control group (P <0.05, The levels of ox-LDL and ox-LDL Ab in SAP group and UAP group were positively correlated with hs-CRP (r = 0.438, r = 0.385, P <0.05, respectively), but not with TG, TG and LDL-C. The levels of TG, TC and LDL-C in each group decreased slightly after treatment, but there was no significant difference between before and after treatment, but no significant decrease in ox-LDL, ox-LDLAb and hs-CRP in control group The levels of ox-LDL, ox-LDLAb and hs-CRP were significantly decreased (P <0.05 respectively). The ox-LDL and ox-LDL Ab were positively correlated with hs-CRP (r = 0.508, r = 0.435; . CONCLUSION: Both ox-LDL and ox-LDLAb can effectively reflect the level of inflammation in vivo, which may be related to the instability of CAS. Short-term lipid-lowering therapy can significantly reduce the serum levels of ox-LDL and ox-LDLAb.