溶血磷脂酸、同型半胱氨酸和D-二聚体对急性冠状动脉综合征的预警作用  

LPA,HCY and D-dimer warning role of acute coronary syndrome

作　　者：王建军[1] 杨超[1] 张琦[1] 高红艳[1] 刘峰瑞 郭洁[1] 王丽[1] 田文华[1] 靳瑞[1] 

机构地区：[1]西安医学院第一附属医院急诊科,西安710077

出　　处：《临床心血管病杂志》2015年第7期717-720,共4页Journal of Clinical Cardiology

基　　金：西安医学院第一附属医院科研计划项目(No:XYFY2013-16)

摘　　要：目的:探讨溶血磷脂酸(LPA)、同型半胱氨酸(HCY)、D-二聚体(D-D)对急性冠状动脉综合征(ACS)的预警作用。方法:102例ACS患者分为急性心肌梗死(AMI)组50例和不稳定型心绞痛(UAP)组52例,另选健康体检者53例作为对照组。所有入选者采静脉血进行LPA、HCY、D-D测定;计算单独检测、两两联合检测以及同时检测LPA、HCY和D-D预警ACS的敏感度和特异度,并相互比较。结果:AMI组和UAP组血清LPA、HCY、D-D水平均明显高于对照组(均P<0.01);AMI组血清LPA、HCY、D-D水平较UAP组升高(均P<0.05);ACS组LPA、HCY、D-D的检测阳性率分别是42.16%、61.76%、46.08%,对照组分别是3.78%、1.89%、1.89%,两组比较有统计学差异(P<0.01);单独检测LPA、HCY、D-D灵敏度分别为42.16%、61.76%、46.08%,特异度分别为96.23%、98.11%、98.11%;两两联合检测的灵敏度分别为69.61%、70.59%、59.80%,特异度分别为94.34%、96.23%、96.23%;3个指标联合检测的灵敏度为76.47%,特异度为94.34%。结论:LPA、HCY、D-D水平与ACS的发生、发展有着密切的关系,联合检测三指标可以显著提高ACS的早期诊断率,对ACS的预警作用最强。Objective：To investigate the early warning role of lysophospholipids acid（LPA）,homocysteine（HCY）and D-dimer（D-D）in acute coronary syndrome（ACS）.Method：Patients（n=102）with ACS were divided into AMI group（n=50）and UAP group（n=52）,53 healthy volunteers were included into control group.All the objects were taken the exsanguinate assay,examination and comparison of LPA,HCY and D-D.Calculation and comparison of the two ACS groups and control group in LPA,HCY,D-D positive rate.The ensitivity and specific degrees were calculated in early warning ACS,single detection,two joint detection,and three indexes of LPA,HCY and D-D were detected at the same time.Result：In contrast with the control group,the serum levels of LPA,HCY and D-D in ACS（including AMI and UAP）patients were increased obviously（all P〈0.01）,the serum levels of LPA,HCY and D-D in AMI patients were higher than those in UAP patients（all P〈0.05）.The LPA,HCY,D-D testing positive rate was 42.16%,61.76% and 46.08% respectively in ACS group,and was3.78%,1.89% and 1.89% respectively in control group,the difference between the two groups was statistical（P〈0.01）.The sensitivity of separate detection of LPA,HCY,D-D was 42.16%,61.76%and 46.08%respectively,specificity was 96.23%,98.11% and 96.23% respectively.Two joint detection sensitivity was 69.61%,70.59% and 59.80% respectively,specificity was 94.34%,96.23% and 94.34% respectively.Joint three index detection sensitivity was 76.47%,specificity was 94.34%.Conclusion：The serum levels of LPA,HCY and D-D are closely correlated with the occurrence and development of ACS.Combined detection of the three indicators can significantly increase the early diagnostic rate of ACS,the warning role of ACS is strongest.

关 键 词：急性冠脉综合征 溶血磷脂酸、同型半胱氨酸、D-二聚体 

分 类 号：R541.4[医药卫生—心血管疾病]