【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。更多还原

【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-PLA2were 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 oxyLDL 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,LpPLA2 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(R~2=20.1%,P<0.05)and baseline BMI(R~2=10.3%,P<0.05)were independent predictors of LpPLA2 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.更多还原