急性冠状动脉综合征患者脂蛋白相关磷脂酶A2的预测价值  

Predictive Value of Lipoprotein-associated Phospholipase A2 in Patients With Acute Coronary Syndrome

作　　者：苗兴妮 尹德录[1] 赵新华[1] 陈宇[1] 周艺[1] 王莹[1] 段平 李群星 

机构地区：[1]连云港市第一人民医院心内科,江苏省222002 [2]徐州医科大学附属连云港医院心内科

出　　处：《中国循环杂志》2017年第12期1172-1176,共5页Chinese Circulation Journal

基　　金：连云港市科技局社会发展计划(SH 1410)

摘　　要：目的:探究脂蛋白相关磷脂酶A2(Lp-PLA2)在急性冠状动脉综合征(ACS)人群中的预测风险价值,及其与冠状动脉狭窄严重程度的相关性。方法:本研究选取入住我院的急性冠状动脉综合征(ACS)患者155例,其中急性心肌梗死49例为急性心肌梗死组,不稳定性心绞痛106例为不稳定性心绞痛组,冠状动脉造影检查结果正常44例为正常对照组,纳入患者均通过荧光免疫层析法检测Lp-PLA2含量,行冠状动脉造影检查,计算GRACE评分、SYNTAX评分及Gensini积分。结果:急性心肌梗死组Lp-PLA2水平明显高于不稳定性心绞痛组及正常对照组,差异有统计学意义(P<0.05)。依据GRACE评分,高危组中Lp-PLA2水平明显高于低危组(P<0.05),相关性分析表明Lp-PLA2与GRACE评分呈正相关(r=0.301,P<0.001)。Lp-PLA2在SYNTAX评分组间及Gensini积分组间,差异均无统计学意义。结论:Lp-PLA2水平对ACS患者在风险评估方面有一定的预测价值,与冠脉狭窄严重程度不相关。Objective： To explore the risk predictive value of lipoprotein-associated phospholipase A2 （Lp-PLA2） on acute coronary syndrome（ACS） and to study the relationship between Lp-PLA2 and the severity of coronary stenosis in ACS patients. Methods：A total of 155 ACS patients admitted in our hospital were enrolled. The patient were divided into 2 groups：AMI （acute myocardial infarction） group, n=49 and UA （unstable angina）group, n=106; in addition, there was a Control group, n=44 subjects with normal coronary angiography （CAG）.Blood levels of Lp-PLA2 were examined, CAG was conducted and GRACE score, SYNTAX score,Gensini score were calculated. Based on Grace score, ACS patients were divided into 3 subgroups： Low risk subgroup, Grace score≤108, Mid risk subgroup,Grace score 109-140 and High risk subgroup,Grace score≥140.The above parameters were comparedamong different groups. Results： Compared with UA group and Control group, AMI group had increased blood level of Lp-PLA2, P〈0.05. Compared with Low risk subgroup, High risk subgroup had much higher Lp-PLA2, P〈0.05. Correlation analysis showed that Lp-PLA2 level was positively related to Gracescore （r=0.301, P〈0.001）. By SYNTAX score and Gensini score evaluation,Lp-PLA2 levels were similar among different subgroups. Conclusion：Blood level of Lp-PLA2 had certain risk predictive value in ACS patients; while it was not related to the severity of coronary stenosis.

关 键 词：急性冠状动脉综合征 磷脂酶类 GRACE评分 

分 类 号：R54[医药卫生—心血管疾病]