血清Lp-PLA2、hs-CRP和D-二聚体在冠心病患者冠脉病变程度中的评估价值  

Assessment the value of serum Lp-PLA2,hs-CRP and D-D dimer on the severity of coronary artery lesion of coronary heart disease

作　　者：李明[1] 

机构地区：[1]武汉科技大学附属天佑医院检验科,武汉430064

出　　处：《重庆医学》2015年第9期1215-1217,1220,共4页Chongqing medicine

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)和D-二聚体在冠心病患者冠脉病变程度中的评估价值。方法选取该院心内科住院部冠心病患者136例(AMI组46例,SAP组38例,UAP组52例)作为观察组和健康体检者135例作为对照组,采用酶动力学方法检测血清Lp-PLA2,免疫比浊法检测血清hs-CRP和D-二聚体,采用Gensini积分评估冠脉病变程度。结果观察组患者血清Lp-PLA2、hs-CRP、D-二聚体水平和Gensini积分均明显高于对照组,AMI组患者上述指标均明显高于SAP组和UAP组,其中UAP组患者均明显高于SAP组,组间比较差异有统计学意义(P<0.05)。心功能Ⅱ级患者血清Lp-PLA2、hs-CRP、D-二聚体水平和Gensini积分均明显低于心功能Ⅲ级和心功能Ⅳ级患者,其中心功能Ⅲ级患者上述指标均明显低于心功能Ⅳ级患者,组间比较差异有统计学意义(P<0.05)。不同冠脉病变程度比较发现,轻度冠状动脉病变患者血清Lp-PLA2、hs-CRP和D-二聚体水平均明显低于中、高度冠状动脉病变患者,且中度冠状动脉病变患者上述指标亦明显低于高度冠状动脉病变患者,差异有统计学意义(P<0.05)。Pearson相关性分析发现,Lp-PLA2、hs-CRP、D-二聚体水平与Gensini积分呈正相关(r=0.642,0.651,0.608,P<0.05)。结论血清Lp-PLA2、hs-CRP和D-二聚体水平在评估冠脉病变程度中具有重要的意义。Objective To investigate the assessment value of serum Lp-PLA2 ,hs-CRP and D-D dimer on the severity of cor-onary artery lesion .Methods A total of 136 patients with coronary heart disease acute myocardial infarction （AMI） group 46 ca-ses ,stable angina pectoris （SAP） group 38 cases and unstable angina pectoris （UAP） group 52 cases from the inpatient of cardiolo-gy department in our hospital were selected as observation group ,and 135 healthy subjects were selected as control group ,serum Lp-PLA2 was detected by enzyme kinetic method ,Serum hs-CRP and plasma D-D dimer were detected by immune turbidimetric method ,of the severity of coronary artery lesion was evaluated by the Gensini integrations .Results Serum Lp-PLA2 ,hs-CRP ,D-D dimer level and Gensini score of observation group were significantly higher than those of control group ,above indexes of AMI group were higher than those of SAP group and UAP group ,UAP group were significantly higher than SAP group ,with statistical significance between the two groups（P〈0 .05） .Serum Lp-PLA2 ,hs-CRP ,D-D dimer level and Gensini score of patients with heart functional class Ⅱwere significantly lower than those of Ⅲ and Ⅳ patients ,above indexes of patients with heart functional class Ⅲwere significantly lower than Ⅳ patients ,the difference between two groups was significant（P〈0 .05） .Compared with severity of coronary artery lesion ,serum Lp-PLA2 hs-CRP and D-D dimer levels of mild coronary artery lesions were significantly lower than those of moderate and high coronary artery lesions ,and moderate coronary artery lesions was obviously lower than high coronary artery lesions （P〈0 .05） ,Pearson correlation analysis also found that ,Lp-PLA2 ,hs-CRP ,D-D dimer levels had positive correlation with Gensini score （r=0 .642 ,0 .651 ,0 .608 ,P〈0 .05） .Conclusion The assessment of serum Lp-PLA2 ,hs-CRP and D-D dimer level in the severity of coronary artery lesion has important significance .

关 键 词：LP-PLA2 D-二聚体 冠心病 冠脉病变 

分 类 号：R541.4[医药卫生—心血管疾病]