单核细胞LP-PLA2 mRNA表达在ST段抬高型心肌梗死再灌注愈后中的预测价值  

Predictive value of LP-PLA2 mRNA expression in monocytes for the prognosisi of patients with ST-elevation myocardial infarction after reperfusion therapy

作　　者：刘爱军[1] 钱雷[2] 张永林[1] 孙敏丽[1] 于建秀[2] LIU Ai-jun 1, QIAN Lei 2, ZHANG Yong-ling 1, SUN Min-li 1, YU Jian-xiu 2(Department of Cardiology 1, Department of Clinical Laboratory 2, Binhai County People＇s Hospital, Yancheng 224500, Jiangsu, CHIN)

机构地区：[1]盐城市滨海县人民医院心内科,江苏盐城224500 [2]盐城市滨海县人民医院检验科,江苏盐城224500

出　　处：《海南医学》2018年第7期901-904,共4页Hainan Medical Journal

基　　金：江苏省盐城市医学科技发展项目(编号:YK2015065)

摘　　要：目的探讨ST段抬高型心肌梗死(STEMI)患者外周血单核细胞脂蛋白磷脂酶A2(LP-PLA2)mRNA表达对STEMI再灌注愈后的预测价值。方法收集2015年5月至2016年6月期间在滨海县人民医院心内科确诊的60例STEMI患者,在行经皮冠状动脉介入治疗(PCI)术前采集外周血,通过PCR法检测单核细胞LP-PLA2mRNA表达,根据Lp-PLA2 mRNA中位值(2.94)分为高Lp-PLA2 mRNA水平组(≥2.94)和低Lp-PLA2 mRNA水平组(<2.94),并行常规生化、心脏超声及冠状动脉造影检查。结果高水平组患者的三支或左主干病变血管比例为66.7%,明显高于低水平组的40.0%,差异有统计学意义(P<0.05);心肌梗塞溶栓治疗(TIMI)心肌灌注分级0~2级患者比例为36.7%,明显多于低水平组的13.3%,差异有统计学意义(P<0.05);高水平组校正的TIMI帧数明显大于低水平组[(24.31±2.01)vs(13.50±1.22)],主要心脏不良事件(MACE)发生率明显高于低水平组(30.0%vs 6.6%),差异均有统计学意义(P<0.05)。受试者工作曲线(ROC)曲线分析结果显示,单核细胞LP-PLA2 mRNA在预测STEMI再灌注愈后中具有较高的特异性和敏感性(cutoff值为3.18时,特异性=0.9000,敏感性=0.8667)。结论单核细胞LPPLA2基因表达水平对STEMI患者再灌注预后有一定的预测价值。Objective To investigate the predictive value of LP-PLA2 mRNA expression in peripheral blood monocytes for the prognisisi of patients with ST-elevation myocardial infarction（STEMI） after reperfusion therapy.Methods A total of 60 patients with STEMI,who were enrolled and diagnosed in Department of Cardiology of Binhai County People＇s Hospital from May 2015 to June 2016,were selected as the research objects.The peripheral blood was collected before percutaneous coronary intervention（PCI）,and the expression of LP-PLA2 mRNA was detected by PCR.According to the median of Lp-PLA2 mRNA（〈2.94）,the patients were divided into the high Lp-PLA2 mRNA level group（≥2.94,high-level group） and low Lp-PLA2 mRNA level group（2.94,low-level group）.Conventional biochemistry,heart echocardiography and coronary artery angiography examination were performed.Results The proportion of the lesion blood vessels in the three branches or the left main in the high-level group was 66.7%,which was significantly higher than 40.0% of the low-level group（P〈0.05）.The proportion of patients with thrombolysis in myocardial infarction（TIMI） of myocardial perfusion grading 0-2 grade in high-level group was 36.7%,which was significantly higher than 13.3% in the low-level group（P〈0.05）.The number of corrected TIMI frames was（24.31±2.01） in the high-level group versus（13.50±1.22） in the low-level group（P〈0.05）.The incidence of major cardiac adverse events（MACE） was30.0% in the high-level group versus 6.6% in the low-level group（P〈0.05）.The receiver operator characteristics（ROC）showed that Lp-PLA2 mRNA in monocytes has high specificity and sensitivity（when the cutoff value was 3.18,the specificity was 0.900 0,the sensitivity was 0.866 7） in predicting the prognosis of after reperfusion therapy for STEMI.Conclusion The level of LP-PLA2 gene expression in monocytes has an important predictive value in patients with STEMI after reperfusion therapy.

关 键 词：ST段抬高型心肌梗死 单核细胞 脂蛋白磷脂酶A2 预测 

分 类 号：R542.22[医药卫生—心血管疾病]