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Objective:To investigate the correlation between serum N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and lipoprotein phospholipase A2 (Lp-PLA2) levels and the severity of coronary artery lesions in patients with acute coronary syndrome (ACS) complicated with type 2 diabetes mellitus (T2DM) .Methods:A total of 68 patients with ACS and T2DM who were admitted to our hospital from Jun. 2018 to Oct. 2020 were selected as the experimental group, and the control group was 52 patients with simple ACS. The serum NT-pro-BNP and Lp-PLA2 levels of the two groups of patients were detected, and the correlation between the serum NT-pro-BNP and Lp-PLA2 levels and the degree of coronary artery disease in patients with ACS complicated with T2DM was analyzed to screen for ACS complicated with T2DM. Influencing factors of moderate to severe coronary artery disease in diabetic patients were selected.Results:The serum levels of NT-pro-BNP[ (349.18±45.98 vs 235.68±26.37) ] ng/L and Lp-PLA2 [ (421.84±55.84 vs 318.62±36.69) ] ng/mL in the experimental group were higher than those in the control group ( P<0.05) . The levels of serum NT-pro-BNP [ (374.35±39.42 vs 320.88±35.41) ] ng/L and Lp-PLA2 [ (452.67±48.32 vs 387.16±40.45) ]ng/mL in the moderate-severe group were higher than those in the mild group ( P<0.05) . Serum NT-pro-BNP and Lp-PLA2 levels were positively correlated with the severity of coronary artery lesions in patients with ACS and T2DM ( r=-0.585, P=0.000; r=-0.595, P=0.000) . Serum NT-pro-BNP and Lp-PLA2 were risk factors for moderate to severe coronary artery disease in patients with ACS complicated with T2DM ( P<0.05) . Conclusion:Serum levels of NT-pro-BNP and Lp-PLA2 in patients with ACS complicated with type 2 diabetes mellitus are related to the degree of coronary artery disease.
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Objective To observe the effect of aerobic exercise combined with impedance training on the blood pressure variability and other blood-related indexes of patients with hypertension. Methods Ninety patients with essential hypertension were randomly divided into group A, group B and group C, each of 30. All were treated with conventional anti-hypertensive drugs. Groups B and C additionally underwent 40 minutes of aerobic training and group C also received resistance training. There were 3 training sessions a week for 12 weeks. Each subject's 24 h systolic blood pressure (24hSBP), 24 h diastolic blood pressure (24hDBP) and their standard deviations were ob-served before and after the 12 weeks. Blood indexes were examined and a plasma arteriosclerosis index was calculated. Results Before the treatment, there were no significant differences in any of the average measurements among the three groups. After the treatment, the average 24hSBP and 24hDBP of all three groups had decreased significantly, but larger decreases were observed in groups B and C. Compared with group B, the average 24hSBP and 24hDBP of group C had decreased significantly more. The average levels of atherogenic index of plasma ( AIP) and lipoprotein phospholipase A2 of groups B and C were significantly lower than before the treatment and also significantly lower than group A's average. The decrease in group C was significantly greater than in group B. Conclusions Anti-hyperten-sive drugs can lower blood pressure, but cannot effectively control blood pressure variation, reduce blood lipids or im-prove the arteriosclerosis index. Long-term, regular aerobic exercise can decrease these indicators and reduce cardio-vascular disease risk in elderly patients with hypertension. Aerobic exercise combined with mild to moderate circulato-ry resistance exercise is more effective than aerobic exercise alone.
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Objective To investigate the effect of enhanced external counterpulsation (EECP) on plasma lipoprotein phospholipase A2 (LP-PLA2) levels, vascular endothelial diastolic function in patients with unstable angina. Methods One hundred patients with unstable angina treated in our hospital were randomly divided into routine treatment group (control group n-49) and external counterpulsation group (observation group n = 51, routine treatment plus external counterpulsation therapy, 60 min/time, a total of 30 times). All selected subjects were tested for LP-PLA2 levels on the day of enrollment and on the 30 th day after treatment, and color Doppler ultrasonography was used to detect arterial blood flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD). Results After treatment in the observation group, LP-PLA2 decreased compared with before treatment, the difference was statistically significant (P < 0.05) , but FMD, NMD were higher than those before treatment, which had statistical difference (P < 0.05). In control group treatment afterwards, LP-PLA2, endothelium-dependent vasodilatation and non-endothelium-dependent vasodilatation did not change significantly before treatment (P> 0.05). Observations between groups showed that the increase in FMD and NMD in the observation group was significantly greater than that in the control group. P < 0.01) , plasma LP-PLA2 levels in the observation group also decreased compared with the control group (P < 0.05). Conclusion Enhanced external counterpulsation can reduce the level of LP-PLA2 in patients and improve endothelial diastolic function under the action of blood flow shear stress.
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Objective To investigate the role of monocyte subsets in the pathogenesis of type 2 diabetes mellitus(T2DM), the expression was detected on lipoprotein-associated phospholipase A2(LP-PLA2) mRNA in peripheral blood monocytes subsets of type 2 diabetic patients. Methods After the peripheral blood of 32 type 2 diabetic patients and 22 healthy controls were collected,the percentages of the monocytes subsets were detected by flow cytometry. The expression of LP-PLA2 mRNA in monocytes subsets were detected by PCR. After monocyte subsets of healthy subjects were induced into macrophages and stimulated by the serum of type 2 diabetic patients for 24h,LP-PLA2 mRNA expression was detected. Results Compared with the control group, the percentage of classical monocytes in T2DM group was decreased, while the LP-PLA2 mRNA expression and percentage of nonclassical,intermediate monocytes were significantly increased(all P<0.05). In addition,the homeostasis model assessment for insulin resistance index was positively correlated with LP-PLA2 mRNA expression in non-classical(P<0.05)and intermediate monocytes(P<0.01)of type 2 diabetic patients. Compared with type 2 diabetic patients without carotid atherosclerosis, the levels of LP-PLA2 mRNA in intermediate and nonclassical monocytes were significantly higher than those in type 2 diabetic patients with carotid atherosclerosis(P<0.05). The level of LP-PLA2 mRNA in non-classical monocytes-derived macrophages stimulated with the serum of type 2 diabetic patients was significantly higher than that in the control group(P<0.05). Conclusion Monocytes subsets from type 2 diabetic patients are abnormally skewed toward to intermediate and non-classical monocytes with high expression of LP-PLA2 mRNA,which may play an important role in the pathogenesis of type 2 diabetes mellitus and atherosclerosis.
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Objective To investigate the predictive value of plasma lipoprotein phospholipase A2 (Lp -PLA2 )and D -dimer in patients with hypertension complicated with stroke.Methods 70 hypertensive patients with stroke were selected as A group,72 patients with simple hypertension were selected as B group,and 71 healthy sub-jects were selected as C group.The light transmitting method was used to detect serum Lp -PLA2 ,and immunoturbi-dimetry was used to detect plasma D -dimer.The clinical value of the two joint detection and single detection in prediction of hypertension complicated with stroke was analyzed.Results The plasma Lp -PLA2 and D -dimer levels of A group were (471.88 ±181.49)ng/mL,(982.54 ±373.28)μg/mL,which were higher than those of B group[(195.17 ±34.74)ng/mL,(263.57 ±29.70)μg/mL]and C group[(122.94 ±46.25)ng/mL,(96.44 ± 8.49)μg/mL](F =189.7,171.1,all P =0.000).The plasma Lp -PLA2 level of A group was positively correlated with D -dimer(r =0.692,P 252g/mL forecast hypertension stroke risk sensitivity was 83.3% and specificity was 98.6%,the plasma Lp -PLA2 >176.36ng/mL forecast hypertension stroke risk sen-sitivity was 92.9% and specificity was 83.1%,and the combined prediction of hypertension stroke risk sensitivity was 87.6%,specificity was 93.5%.Conclusion The plasma levels of Lp -PLA2 and D -dimer are significantly increased in hypertensive patients with stroke,and the combined detection of the two indicators can improve the prediction of stroke risk in patients with hypertension.
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Objeetive To investigate the clinical significance of combined detection of lipoprotein associated serum phospholipase A2 (Lp-PLa2),homocysteine (Hcy) and cystatin C (CysC) in the diagnosis of hypertensive disorders complicating pregnancy (HDCP).Methods From January 2013 to May 2016 in Changan Hospital,selected 113 cases of pregnancy induced hypertension patients as the observation group,and were divided into three group A,B and C (group A:55 cases of HDCP patients,group B:32 cases of mild preeclampsia and group C for patients with severe preeclampsia 26 cases).At the same period,selected 50 cases of normal college pregnancy as control group,serum Lp-PLa2 (enzyme-linked immunosorbent assay),Hcy (cyclophorase method) and CysC (particle enhanced turbidimetric method),the test results were analyzed and compared.Results Serum Lp-PLa2,Hcy and CysC test results in the control group,the observation group A,observation group B and observation group C increased significantly,in the observation group C increased most obviously.Compared with the control group,the serum levels of Lp-PLa2,Hcy and CysC in the observation group were significantly higher,the difference was statistically significant (F=8.102,7.231 and 6.926,all P＜0.05).Pearson correlation analysis showed that there was a positive correlation between serum Lp-PLa2,Hcy and CysC and blood pressure (r=0.71,0.69,0.63,all P＜0.05).The abnormal rate of serum Lp-PLa2,Hcy and CysC for three joint detection was higher than that of single detection,and the difference was statistically significant (x2 =6.725,P＜0.001).The abnormal rate of serum Lp-PLa2,Hcy and Cys single test results increased with the exacerbation of HDCP,and the difference was statistically significant (x2=9.351,P＜0.000).Conclusion Serum Lp-PLa2,Hey,CysC and pregnancy would be closely related to the occurrence and development of hypertension syndrome,so combined detection of HDCP can improve the detection rate of abnormal results,and it has important clinical significance for early diagnosis and prognosis of HDCP.
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Objective To observe the effect of sequential therapy of butylphthalide injection and soft capsules for acute cerebral infarction and its influence on plasma lipoprotein phospholipase A2.Methods 120 patients with cerebral infarction were selected in the study,and they were divided into observation group (64 cases) and control group(56 cases) according to the digital table.The control group received conventional therapy plus placebo,the observation group received the sequential administration of butylphthalide injection and butylphthalide soft capsule treatment based on the conventional treatment.Before and after treatment,the plasma lipoprotein phospholipase A2 of the two groups was detected,and the National Institutes of Health Stroke Scale (NIHSS) was evaluated,compared neurological deficit improvement between the two groups and recorded adverse drug reactions of the two groups.Results There were no significant differences in NIHSS score and plasma lipoprotein phospholipase A2 level between the two groups before treatment(all P ＞ 0.05).After treatment,the NIHSS score of neurological impairment,plasma lipoprotein phospholipase A2 level in the observation group were (6.40 ± 5.22) points,(203.26 ± 29.33) ng/mL,those in the control group were (8.59 ± 6.22) points,(253.10 ± 52.99) ng/mL,the differences were statistically significant(t =-1.36,-2.089,P =0.039,0.000).The total effective rate of the observation group was 90.6％,which was higher than 67.9％ of the control group,the difference was statistically significant (x2 =9.676,P =0.002).The incidence rate of adverse reactions was similar in the two groups (P ＞ 0.05).Conclusion Sequential therapy of butylphthalide for acute cerebral infarction can improve the neurological function,decrease the level of plasma lipoprotein phospholipase A2,inhibit the inflammation of blood vessels,improve the prognosis of patients.
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Objective @# To discuss the changes of serum lipoprotein phospholipase A2 (Lp - PLA2) and c-reactive protein (CRP) levels in atorvastat in treatment for the patients with periodontitis and hyperlipidemia.@*Methods @# 148 patients with periodontitis and hyperlipidemia were involved, and divided into basic group (foundation treatment, 82 cases) and statin group (foundation treatment plus 20 mg atorvastatin treatment, 66 cases). 40 healthy cases from the medical center health personnel were selected as the healthy group. Attachment levels (AL), bleeding index (BI), serum total cholesterol (TC), triacylglycerol (TG), Lp - PLA2, and CRP levels were checked and compared before and after 6 months of treatment. Lp - PLA2 and CRP were checked by enzyme linked immunosorbent assay (ELISA), and their relationship were analyzed by the method of Pearson. @*Results@# When the disease group were compared with the healthy group, the statistics were as follows: AL（3.92 ± 0.51 mm vs 0.42 ± 0.06 mm）, BI（2.81 ± 0.48 vs 0.34 ± 0.05）, TC（5.27 ± 0.83 mmol/L vs 4.02 ± 0.62 mmol/L）, TG（2.67 ± 0.41 mmol/L vs 0.93 ± 0.17 mmol/L）, Lp-PLA2（243.57 ± 58.71 μg/L vs 132.24 ± 34.27 μg/L）, CRP（9.72 ± 3.27 μg/L vs 3.21 ± 0.87 μg/L）, and the statistics of disease group were significantly higher than the healthy group with a significant difference (P< 0.05). When Statin group was compared with basis group, the statistics were as follows: AL（3.70 ± 0.10 mmvs 3.78 ± 0.11 mm）, BI（1.05 ± 0.28 vs 1.43 ± 0.32）, TC（3.82 ± 0.67 mmol/L vs 4.51 ± 0.71 mmol/L）, TG（1.30 ± 0.29 mmol/L vs 1.83 ± 0.34 mmol/L）, Lp-PLA2（157.43 ± 40.18 μg/L vs 199.43 ± 47.24 μg/L）, CRP（4.21 ± 3.02 μg/L vs 6.37 ± 3.28 μg/L）, and the statistics of statin group were lower than that in basis group with a significant difference (P< 0.05). Pearson analysis showed Lp-PLA2 and CRP levels were positively correlated (r = 0.672, P< 0.05). @*Conclusion@#It shows the changes of Lp- PLA2 and CRP level were related with the clinical conditions of periodontitis combined with hyperlipidemia, and atorvastatin therapy can effectively reduce the body's blood lipid levels, and improve the treatment effects of periodontitis combined with hyperlipidemia.
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Objective To detect the effect ofXuebijing injection on the serum soluble CD40 ligand (soluble CD40 ligand, sCD40L), lipoprotein associated phospholipase A2 (lipoprotein-phospholipase A2, Lp-PLA2) of patients with acute coronary syndrome (ACS).Methods A total of 120 patients with ACS were randomized divided into the control group and treatment group, 60 in each group.The control group received the routine treatment of Western medicine, and the treatment group receivedXuebijing injectionbased on the intervention of control group. Both groups were treated for 2 weeks. ELISA method was used to detect serum sCD40L, Lp-PLA and IL-6, TNF-α and CRP.Results After treatment, the serum sCD40L(320.62 ± 35.81 pg/Lvs. 401.70 ± 4.84 pg/L, t=10.435), Lp-PLA2 (203.62 ± 33.13μg/L vs. 296.45 ± 4.422μg/L,t=12.831) level was significantly lower than those in the control group (P<0.01); The serum CRP (3.10 ± 2.00 mg/Lvs.4.74 ± 2.04 mg/L,t=4.006), IL-6 (2.10 ± 1.20 pg/Lvs.3.14 ± 1.40 pg/L,t=3.781), TNF (2.81 ± 1.50 pg/Lvs. 3.70 ± 1.70 pg/L,t=3.075) level was significantly lower than thosein the control group (P<0.01 orP<0.05). Compared with the control group, the effect rate (68.3%vs. 50.0%,χ2=4.174) of the treatment group was significantly higher (P=0.041).ConclusionXuebijing injection can improve the therapeutic effectof ACS patients, and reduce CD40L, Lp-PLA2 levels.