Effect of omega-3 polyunsaturated fatty acid on lipoprotein-associated phospholipase A2 in patients with unstable angina
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摘要:
目的 探讨ω-3多不饱和脂肪酸对不稳定型心绞痛患者脂蛋白相关性磷脂酶A2的影响。 方法 选取广东省2家三甲医院60例经皮冠状动脉介入治疗成功的不稳定型心绞痛患者，随机分成对照组和试验组，每组30例。对照组患者术后接受常规的阿司匹林及氯吡格雷治疗，试验组除了接受上述药物治疗外，每日添加服用ω-3 PFUA 1000 mg，记录两组患者一般临床资料，分别在服用ω-3 PFUA前，服用后2周和服用后4周检测患者氧化-LDL和Lp-PLA2等指标。 结果 两组患者一般临床资料差异无统计学意义（P>0.05），两组患者服用ω-3 PFUA前Lp-PLA2和氧化LDL水平差异无统计学意义（P>0.05），对照组患者服用ω-3 PFUA 2周及4周后Lp-PLA2和氧化LDL水平与服用前比较差异无统计学意义（P>0.05），试验组服用ω-3 PFUA 2周及4周后患者Lp-PLA2和氧化LDL水平均显著低于服用前及对照组患者（P<0.05）。Lp-PLA2水平与患者BMI呈正相关（r=0.32，P<0.05）。服用ω-3 PFUA（R2=20.1%，P<0.05）和体质量指数（R2=10.3%，P<0.05）为Lp-PLA2水平变化的独立预测因素。 结论 ω-3 PFUA可显著降低不稳定型心绞痛PCI术后患者的Lp-PLA2水平，这可能是ω-3 PFUA预防心血管疾病发生的潜在机制之一。 -
关键词:
- 多不饱和脂肪酸 /
- 不稳定型心绞痛 /
- 脂蛋白相关性磷脂酶A2
Abstract:Objective To confirm the effect of omega-3 polyunsaturated fatty acid (PFUA) on lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with unstable angina. Methods 60 patients with unstable angina after successful percutaneous coronary intervention (PCI) were randomly divided to control group and experimental group (n = 30). Patients in the control group received aspirin and clopidogrel treatment after PCI, and patients in the experimental group received additional omega-3 PFUA 1000 mg every day. Patients’ clinical data in both groups were collected, and oxy-LDL and Lp-PLA2 were detected before and 2 and 4 weeks after omega-3 PFUA treatment. Results There were no significant differences in the clinical data and in Lp-PLA2 and oxy-LDL before omega-3 PFUA treatment between the experimental group and the control group (P>0.05). Two and four weeks after omega-3 PFUA treatment, there were no significant differences in Lp-PLA2 and oxy-LDL in the control group when compared to that before omega-3 PFUA treatment (P>0.05), but Lp-PLA2 and oxy-LDL in the experimental group were significantly lower when compared to that before omega-3 PFUA treatment (P<0.05). Moreover, Lp-PLA2 were positively correlated with baseline body mass index (BMI,r=0.32, P<0.05). The multivariate model showed that treatment with omega-3 PUFA (R2=20.1%, P<0.05) and baseline BMI (R2=10.3%, P<0.05) were independent predictors of Lp-PLA2 changes at 4 weeks. Conclusion Omega-3 PFUA could significantly reduce Lp-PLA2 in with unstable angina undergoing PCI, which might be a potential mechanism for omega-3 PFUA in cardiovascular disease prevention. -
表 1 两组患者临床资料比较
指标 对照组 试验组 女性，n（%） 10（33.3） 11（36.7） 年龄（年） 61.3±10.1 62.2±9.8 BMI，kg/m2 25.2±5.3 25.0±4.8 腰围（cm） 91.9±33.1 92.3±36.2 冠心病病史（年） 7.7±4.8 7.3±5.1 高血压病史，n（%） 28（93.3） 29（96.7） 2型糖尿病病史，n（%） 8（26.7） 7（23.3） 高血脂病史，n（%） 28（93.3） 27（90） 吸烟史，n（%） 12（40） 13（43.3） 
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表 2 两组患者不同时间点Lp-PLA2水平比较（Mean±SD，ng/mL）
组别 服用前 服用后2周 服用后4周 对照组 281.78±40.13 286.72±38.24 291.86±43.69 试验组 283.19±43.82 260.42±35.37ab 231.21±30.91ab 与服用前比较, aP<0.05; 与对照组比较,bP<0.05.
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表 3 两组患者不同时间点氧化LDL水平比较（Mean±SD，μg/L）
组别 服用前 服用后2周 服用后4周 对照组 80.68±20.15 81.87±25.58 82.26±24.98 试验组 81.13±22.72 65.33±23.18ab 50.62±20.89ab 与服用前比较, aP<0.05; 与对照组比较,bP<0.05.
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