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Research on the Pathophysiological Roles of Lipoprotein(a) Combined to Lysine

Author: ZhangJinHong
Tutor: LiuAiBing
School: Liaoning Medical
Course: Clinical Laboratory Science
Keywords: Lipoprotein(a) Lp(a)ly~+ Lysine Plasminogen Infection Acute myocardial infarction Malignancy
CLC: R363
Type: Master's thesis
Year: 2011
Downloads: 20
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Abstract


ObjectiveTo survey the concentration of Lipoprotein(a)[Lp(a)] in healthy and disease people. To explore the causes for changes in many disease groups. To compare Lp(a) level as an experimental diagnosis marker in both immune turbidity assay(ITA) and enzyme-linked immuno sorbent assay(ELISA). To establish a method of measuring functional Lp(a)[Lp(a)ly~+] level and to appraise the experimental diagnostic value of the method in acute cardiovascular events and infectious pneumonia. To explore the mechanism of Lp(a)ly~+ participating in occurrence and development of disease. And to provide a further research tool for pathophysiological roles of Lp(a).MethodsThe quantity of Lp(a) was tested by the ITA in a cross-sectional large sample statistical studies. The distribution of Lp(a) level in the healthy and disease groups was screened by Excel and SPSS17.0 statistics software. Both method of ELISA and ITA to quantitate Lp(a) was compared in many disease groups. The method of measured functional Lp(a)----Lp(a)ly~+ was established by indirect ELISA, and its experimental diagnosis effect was valued in acute myocardial infarction and infectious pneumonia.Results1. The cross-sectional statistics result of the large sample was found: Dispersion of Lp(a) level was from 0～1743.50mg/L in the investigated people. It’s slightly higher than the healthy group (P<0.05) only in the patient groups of cardiovascular, urinary and nervous system disease. Infection group significantly higher than healthy group (P<0.05). Ages was no significant difference between the groups (P>0.05). Lp(a) level in female slightly higher than in male (P<0.05) in healthy groups, cerebral infarction group and CHD group.2. Lp(a) of case retrospective studies were found: It was higher than healthy control group (P=0.03) in acute myocardial infarction (AMI), slightly higher in unstable angina group (UA) (but P>0.05). The level of Lp(a)≥300mg/L was significant difference than < 300mg/L in cardiovascular disease(P < 0.05). The risk of Lp(a)≥300mg/L was 1.44 times than <300mg/L in cardiovascular disease.3. Methodology was evaluated: Total Lp(a) quality was tested using ITA and ELISA. ITA method was more sensitive than ELISA(>1000 times) and two methods cannot be compared. Lp(a) levels in UA, AMI and bacterial pneumonia groups have no change during their course of disease(P>0.05).4. The method of measured functional Lp(a)----Lp(a)ly~+ was established by indirect ELISA: Its accuracy was higher and recovery test results in 80～90%. Linear testing R~2 value was 0.84. High concentrations of total bilirubin, hemoglobin and triglyceride was less disturbing the results.5. Diagnostic value of Lp(a)ly~+ for AMI: Lp(a)ly~+ can effectively diagnose AMI (ROC curves area=1) with indirect ELISA method. The accuracy, specificity and youden index was higher than the Creatine Kinase isozyme (CK - MB) in diagnosing AMI.6. Diagnostic value of Lp(a)ly~+ for pneumonia: Lp(a)ly~+ level in pneumonia patients was obviously higher than that of the control group (P<0.05). Lp(a)ly~+ was significantly changed in its course of disease. it may be an useful marker in directing medicine treatment and monitoring the course of disease. Conclusions1. Lp(a) may be involved in the process of the atherosclerosis formation and development.2. Lp(a) may be involved in the body’s resistance to infection and inflammation. It may participate in the occurrence and development of the malignant tumor.3. Current methods for mearuring Lp(a) both ITA and ELISA have some shortcomings, In particular,functional Lp(a) can not be found.4. Estabalished functional Lp(a)---[Lp(a)ly~+] method offered a high accuracy and broader Linear. High concentrations of total bilirubin, hemoglobin and triglyceride were less disturbing the results.5. Lp(a)ly~+ was an acute phase protein for myocardial injury, can monitor the occurrence and development of AMI.6. Lp(a)ly~+ was a kind of anti-infection immune factor, participating in the infection immune response of acute bacterial pneumonia. It‘s great significance for the diagnosis and monitoring of pneumonia.7. Lp(a)ly~+, as a functional Lp(a), may participate in anti-infection and tumor metastasis. Detecting method of Lp(a)ly~+ provided a useful tool for researching the pathophysiological function of Lp(a) in future. Purified Lp(a)ly~+ and established more sensitive and specific method should be researched.

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