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Impact of Serum Level of Lipocalin-Type Prostaglandin D Synthase on Coronary Atherosclerosis

血清脂质运载蛋白型前列腺素D合酶水平对冠状动脉粥样硬化的影响

基本信息

批准号：
13670755
负责人：
OZAKI Yukio
金额：
$ 2.3万
依托单位：
Aichi Medial University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2001
资助国家：
日本
起止时间：
2001 至 2003
项目状态：
已结题

项目摘要

Although coronary risk factors including hyperlipidemia, hypertension and diabetes relate to coronary atherosclerosis, it still debates whether the presence of risk factors have enough ability to select the individual patient with CAD out of ordinary patient population. While lipocalin-type-prostaglandin-D-synthase (L-PGDS) has recently known to be localized in the human coronary atherosclerotic plaque, the serum L-PGDS has been found to mainly derive from the plaque. Whereas intracoronary ultrasound (ICUS) provides unique tomographic information of coronary mural pathology, atherosclerotic plaque burden assessed by ICUS would correlate to L-PGDS. We prospectively performed quantitative angiography (QCA) and measured serum L-PGDS level in 174 patients. Of the patients 42 had normal-coronary-artery (NCA), 67 single vessel disease (SVD), 49 double vessel disease (DVD) and 16 triple vessel disease (TVD). L-PGDS was compared among four groups. Eighty-three had coronary interventions (PCI) with IVUS. Of the 174 L-PGDS was the lowest in NCA and the highest in TVD. The L-PGDS level was gradually higher according to the severity of coronary atherosclerosis. The serum L-PGDS level in DVD and TVD was significantly higher than that in NCA (p<0.05). While a weak correlation was observed between plaque area (PLA) by IVUS and coronary risk factors (PLA versus HDL ; r=-0.19, PLA versus LDL ; r=-0.10, PLA versus FBS ; r=-0.01) in the 83 patients with ICUS, moderate and significant correlation was obtained between PLA and L-PGDS (r=0.51, p<0.001). Serum L-PGDS level significantly increased in proportion to the severity of CAD. Although conventional coronary risk factors indicated weak correlation to the extent and severity of coronary atherosclerosis by ICUS, L-PGDS showed acceptable correlation to coronary plaque burden by IVUS. The assessment of L-PGDS would be useful to select high-risk patients with advanced coronary atherosclerosis out of usual patient population.

尽管包括高脂血症、高血压和糖尿病在内的冠状动脉危险因素与冠状动脉粥样硬化有关，但危险因素的存在是否足以从普通患者群体中选择出患有冠心病的个体患者仍存在争议。虽然最近已知脂质运载蛋白型前列腺素-D-合酶（L-PGDS）位于人冠状动脉粥样硬化斑块中，但已发现血清L-PGDS主要源自斑块。虽然冠状动脉内超声 (ICUS) 提供冠状动脉壁病理学的独特断层扫描信息，但 ICUS 评估的动脉粥样硬化斑块负荷将与 L-PGDS 相关。我们前瞻性地对 174 名患者进行了定量血管造影 (QCA) 并测量了血清 L-PGDS 水平。其中 42 名患者患有正常冠状动脉 (NCA)，67 名患者患有单血管疾病 (SVD)，49 名患者患有双血管疾病 (DVD)，16 名患者患有三支血管疾病 (TVD)。比较四组之间的 L-PGDS。 83 人接受了 IVUS 冠状动脉介入治疗 (PCI)。在 174 个 L-PGDS 中，NCA 最低，TVD 最高。根据冠状动脉粥样硬化的严重程度，L-PGDS水平逐渐升高。 DVD和TVD中血清L-PGDS水平显着高于NCA（p<0.05）。虽然在 83 名 ICU 患者中观察到 IVUS 斑块面积 (PLA) 与冠状动脉危险因素之间存在弱相关性（PLA 与 HDL；r=-0.19，PLA 与 LDL；r=-0.10，PLA 与 FBS；r=-0.01），但 PLA 和 L-PGDS 之间存在中度和显着相关性（r=0.51，p<0.001）。血清 L-PGDS 水平随 CAD 严重程度的增加而显着升高。虽然传统的冠状动脉危险因素显示 ICUS 与冠状动脉粥样硬化的程度和严重程度的相关性较弱，但 IVUS 表明 L-PGDS 与冠状动脉斑块负荷的相关性可接受。 L-PGDS 的评估有助于从普通患者群体中选择患有晚期冠状动脉粥样硬化的高危患者。