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目的:研究超敏C反应蛋白(hs-CRP)、D-二聚体和脂蛋白相关磷脂酶A2(Lp-PLA2)与冠心病患者冠状动脉粥样硬化易损斑块的相关性。方法:选择2014年1月~2016年12月在我院进行冠状动脉造影和血管内超声检查的患者106例,按照检查结果分为易损斑块组、稳定斑块组和对照组。检测和比较三组患者的血清hs-CRP、D-二聚体和Lp-PLA2水平,并采用Pearson相关分析探讨其与纤维帽厚度、斑块偏心指数和血管重构指数的相关性。结果:易损斑块组和稳定斑块组的血清hs-CRP、D-二聚体和Lp-PLA2水平明显高于对照组(P<0.05),且易损斑块组的血清hs-CRP、D-二聚体和Lp-PLA2水平明显高于稳定斑块组(P<0.05)。hs-CRP与纤维帽厚度呈负相关(r=-0.712,P<0.05),与斑块偏心指数和血管重构指数呈正相关(r=0.813,0.756,P<0.05);D-二聚体与纤维帽厚度呈负相关(r=-0.654,P<0.05),与斑块偏心指数和血管重构指数呈正相关(r=0.912,0.853,P<0.05);Lp-PLA2与纤维帽厚度呈负相关(r=-0.796,P<0.05),与斑块偏心指数和血管重构指数呈正相关(r=0.836,0.729,P<0.05)。结论:hs-CRP、D-二聚体和Lp-PLA2与冠心病患者冠状动脉粥样硬化易损斑块具有较高的相关性,可作为评估冠状动脉粥样斑块不稳定性的参考指标。
Objective: To investigate the correlation between hs-CRP, D-dimer and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with coronary atherosclerotic plaque. Methods: A total of 106 patients underwent coronary angiography and intravascular ultrasound in our hospital from January 2014 to December 2016 were divided into vulnerable plaque group, stable plaque group and control group according to the examination results. The levels of serum hs-CRP, D-dimer and Lp-PLA2 in three groups were detected and compared. Pearson correlation analysis was used to investigate the correlation between the changes of fibrin cap thickness, plaque eccentricity index and vascular remodeling index. Results: The levels of hs-CRP, D-dimer and Lp-PLA2 in the vulnerable plaque group and the stable plaque group were significantly higher than those in the control group (P <0.05), and the levels of hs-CRP , D-dimer and Lp-PLA2 levels were significantly higher than those in the stable plaque group (P <0.05). hs-CRP was negatively correlated with the thickness of fibrous cap (r = -0.712, P <0.05), and positively correlated with the eccentricity index and vascular remodeling index (r = 0.813,0.756, P <0.05) (R = -0.654, P <0.05), and positive correlation with plaque eccentricity index and vascular remodeling index (r = 0.912,0.853, P <0.05). The thickness of Lp-PLA2 and fibrous cap Negative correlation (r = -0.796, P <0.05), positive correlation with plaque eccentricity index and vascular remodeling index (r = 0.836,0.729, P <0.05). CONCLUSIONS: There is a high correlation between hs-CRP, D-dimer and Lp-PLA2 in patients with coronary atherosclerotic vulnerable plaque and can be used as a reference index for assessing atherosclerotic plaque instability .