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目的探讨急性冠状动脉综合征(acute coronary syndrome,ACS)患者血浆环氧二十碳三烯酸(epoxyeicosatrienoic acids,EET)水平与血脂的关系,分析血浆EET对ACS患者主要心血管事件的影响。方法 ACS患者120例为ACS组,体检健康者120例为对照组,采用ELISA法测定2组血浆EET及血脂水平;以ACS组EET中位数(68.5μg/L)为切点,将ACS患者分为高EET水平组(EET≥68.5μg/L)和低EET水平组(EET<68.5μg/L),随访6个月,观察各组主要心血管事件发生情况。结果ACS组患者血浆EET水平[(63.25±2.08)μg/L)]低于对照组[(88.16±3.44)μg/L)](P<0.05),总胆固醇[(5.68±0.39)mmol/L]、低密度脂蛋白胆固醇[(2.93±0.27)mmol/L]高于对照组[(4.16±0.15)、(1.56±0.13)mmol/L](P<0.05);ACS组患者EET水平与低密度脂蛋白胆固醇呈负相关(r=-0.953,P=0.014),与三酰甘油、总胆固醇和高密度脂蛋白胆固醇无明显相关性(r=0.251,P=0.467;r=-0.463,P=0.212;r=0.316,P=0.411);随访6个月,对照组无主要心血管事件发生,低EET水平组主要心血管事件发生率(27.8%)高于高EET水平组(6.5%)(P<0.05);多因素logistic回归分析显示,校正其他危险因素后,EET<68.5μg/L是ACS患者发生主要心血管事件的独立预测因素(OR=2.868,95%CI:1.152~8.474,P=0.012)。结论ACS患者血浆EET水平降低,且与低密度脂蛋白胆固醇水平呈负相关,血浆EET水平可作为ACS发生主要心血管事件的独立预测因素。
Objective To investigate the relationship between plasma levels of epoxyeicosatrienoic acids (EET) and blood lipids in patients with acute coronary syndrome (ACS) and analyze the influence of plasma EET on major cardiovascular events in patients with ACS. Methods One hundred and twenty ACS patients were enrolled as ACS group and 120 healthy control subjects as control group. Plasma EET and blood lipid levels were measured by ELISA. The median EET of ACS group (68.5μg / L) The patients were divided into high EET group (EET≥68.5μg / L) and low EET group (EET <68.5μg / L) for 6 months. The incidence of major cardiovascular events in each group were observed. Results The level of plasma EET in ACS group was significantly lower than that in control group [(63.25 ± 2.08) μg / L [(88.16 ± 3.44) μg / L vs (2.93 ± 0.27) mmol / L] were significantly higher than those in the control group [(4.16 ± 0.15) and (1.56 ± 0.13) mmol / L], respectively (R = -0.953, P = 0.014), and no significant correlation with triglyceride, total cholesterol and high density lipoprotein cholesterol (r = 0.251, P = 0.467; r = -0.463, P = 0.212; r = 0.316, P = 0.411). No major cardiovascular events occurred in the control group at 6 months of follow-up. The incidence of major cardiovascular events in the low EET group was significantly higher than that in the high EET group (27.8% vs 6.5% (P <0.05). Multivariate logistic regression analysis showed that EET <68.5μg / L was an independent predictor of major cardiovascular events after adjustment for other risk factors (OR = 2.868,95% CI: 1.152-8.474, P = 0.012). Conclusions Plasma EET levels are decreased in patients with ACS and negatively correlated with low density lipoprotein cholesterol levels. Plasma EET levels may be used as independent predictors of major cardiovascular events in patients with ACS.