冠心病患者血清Lp-PLA2与HCY检测及其与冠状动脉病变程度的相关性分析  

Detection of Serum Lp-PLA2 and HCY in Patients with Coronary Heart Disease and Its Correlation with the Degree of Coronary Artery Disease

作　　者：刘亚东[1] 冯莉莉[1] 王海晶 王丽萍 李永莉 LIU Ya- dong1 ,FENG Li- li1 ,WANG Hai- jing1 ,WANG Li- ping1 ,LI Yong- li2(Department of Clinical Laboratory, Department of Cardiovascular and Cerebrovascular Disease, Affiliated Hospital of Yan＇ an University, Shaanxi Yan＇ an 71G000, China; 2. Department of Clinical Laboratory, Ankang Hanbin District Second Hospital, Shaanxi Ankang 725021, China)

机构地区：[1]延安大学附属医院心脑血管病区检验科,陕西延安716000 [2]安康市汉滨区第二医院检验科,陕西安康725021

出　　处：《现代检验医学杂志》2018年第6期83-87,共5页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)和同型半胱氨酸(HCY)水平检测与冠心病(CHP)患者冠状动脉病变程度的关系。方法选取2017年1月～2018年5月延安大学附属医院经冠状动脉造影确诊的冠心病患者266例为实验组,其中男性161例,平均年龄57.3±8.5岁,女性105例,平均年龄61.1±11.6岁,选取同期该院冠状动脉造影阴性的体检者180例为对照组,其中男性97例,平均年龄54.6±10.5岁,女性83例,平均年龄47.5±6.3岁,记录两组性别、年龄、糖尿病史、卒中病史、心肌梗死病史、吸烟史和饮酒史,使用贝克曼AU2700全自动生化分析仪测定两组HCY,Lp-PLA2,空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDLC)和脂蛋白(a)[Lp(a)]水平,分析两组各项指标的差异。秩和检验比较Gensini积分组[低积分组(Gensini积分<14分,n=128),中积分组(Gensini积分14～28分,n=83),高积分组(Gensini积分>28分,n=55)共3组]Lp(a),HCY水平之间的差异,秩和检验比较冠状动脉不同支数病变组[1支病变组(n=87)、2支病变组(n=91)、3支及3支以上病变组(n=88)共3组]Lp(a),HCY水平之间的差异。采用Pearson法分析Gensini积分与Lp-PLA2,HCY水平之间的相关性及LpPLA2与HCY水平之间的相关性。结果实验组与对照组吸烟史、饮酒史及HCY,Lp-PLA2,Lp(a)水平为:59.77%vs38.9%,86.84%vs 76.67%,53.7±21.8μmol/L vs 6.5±4.1μmol/L,366.1±114.3μg/L vs 115.4±48.4μg/L,569±283mg/L vs 107±75.8mg/L,差异均有统计学意义(t或χ~2=7.78～18.75,均P<0.05)。Gensini低积分组、中积分组、高积分组HCY和Lp-PLA2水平为:39.6±20.2μmol/L,50.7±26.4μmol/L,68.5±31.8μmol/L和245.4±88.3μg/L,326.1±104.3μg/L,459.4±113.5μg/L,差异均有统计学意义(Z=5.81,15.25,均P<0.05)。冠状动脉1支病变组、2支病变组、3支及3支以上病变组HCY和Lp-PLA2水平为:48.6±27.2μmol/L,47.8±23μmol/L,74.1±38.6μmol/L和201.4±73.5μg/L,344.1±134.2μg/LObjective to explore the correlation between serum lipoprotein related phospholipase A2（Lp PLA2） and homo cysteine （HCY） levels and the degree of coronary artery disease in patients with coronary heart disease. Methods Selection methods between January 2017 and May 2018, delay of establishing affiliated hospital after coronary angiography diagnosis of 266 patients with coronary heart disease （CHD） as the experimental group, 161 cases of men, average age （57.3 ± 8.5 years）, ]05 cases of female,average age （61.1 ± 11. 6 years）, select the same negative coronary angiography in our medical 180 cases as control group,97 cases of men, average age （54.6±10.5 years）,83 cases of female,average age （47.5± 6.3 years）, History records of two groups of gender, age, diabetes mellitus, history of stroke, myocardial infarction, history, his tory of smoking, drinking alcohol, using beckman AU2700 automatic biochemical analyzer determination of two groups of HCY, Lp PLA2, fasting blood glucose （FBG）, three acyl glycerin （TG）, total cholesterol （TC）, low density lipoprotein cho lesterol （LDL C）, high density lipoprotein cholesterol （HDL C）, lipoprotein （a）ELp （a）]level, analysis the difference of each index in both groups. Rank and inspection comparison Gensini score [low score group （Gensini score 〈14 points, n =128）, the integral group （Gensini score 14 -28 points, n=83） , the high score group （Gensini score 〉28 points, n=55） a total of three groups] Lp （a）,the difference between HCY levels, rank and inspection comparison of coronary artery counts lesion group [1 lesion group （n=87） ,two lesion group （n=91） ,more than three and three lesion group （n=88） ,a total of 3] Lp （a） ,the difference between HCY levels. Pearson method was used to analyze the correlation between Gensini integral and Lp PLA2 and HCY levels and the correlation between Lp PLA2 and HCY levels. Results The smoking and drinking histo ry of the experimental group and th

关 键 词：冠心病 脂蛋白相关磷脂酶A2 同型半胱氨酸 冠状动脉粥样硬化 GENSINI积分 

分 类 号：R541.4[医药卫生—心血管疾病] R446.112[医药卫生—内科学]