血清Lp-PLA2水平在肝硬化合并高血压患者中的临床意义  

Clinical significance of the level of serum Lp-PLA2 in patients with liver cirrhosis and hypertension

作　　者：邢继成 马立彬 何玉杰[1] 楼小伟[1] 朱月蓉[1] 邱红[1] XING Jicheng;MA Libin;HE Yujie;LOU Xiaowei;ZHU Yuerong;QIU Hong(Department of Clinical Laboratory,Bayi Hospital Affiliated Nanjing Universityof Chinese Medcine,Nanjing,Jiangsu 210002,China;Department of Pharmacology,GuangxiInstitute For Food And Drug Control,Nanning,Guangxi 530021,China)

机构地区：[1]南京中医药大学附属八一医院检验科,南京210002 [2]广西食品药品检验所药理室,南宁530021

出　　处：《检验医学与临床》2018年第23期3539-3541,3545,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平在肝硬化合并高血压患者中的临床意义。方法选取2016年3月至2017年4月在南京中医药大学附属八一医院住院的高血压及乙型肝炎肝硬化患者共292例为研究对象。将其分为肝硬化组79例和高血压组114例,肝硬化患者又分为肝硬化代偿组26例、失代偿组53例;高血压患者按照危险分层分为Ⅰ、Ⅱ级组27例和Ⅲ级组87例;肝硬化合并高血压组99例,其中肝硬化失代偿合并高血压Ⅲ级组55例。采用免疫散射比浊法检测Lp-PLA2水平,各组间同时进行比较。采用受试者工作特征曲线(ROC曲线)对Lp-PLA2的诊断价值进行分析。结果 Lp-PLA2水平在高血压Ⅲ级组明显高于Ⅰ、Ⅱ级组,差异有统计学意义(P<0.05);肝硬化失代偿组明显高于代偿组,差异有统计学意义(P<0.05);肝硬化失代偿合并高血压Ⅲ级组既明显高于单纯肝硬化失代偿组,也明显高于单纯高血压Ⅲ级组,差异有统计学意义(P<0.05)。经过ROC曲线分析,Lp-PLA2诊断肝硬化失代偿合并高血压Ⅲ级的曲线下面积为0.891,CUT-OFF值为341.5ng/mL。结论 Lp-PLA2水平对高血压危险程度和肝硬化病程进展有提示作用,可作为其病程监测和调整临床治疗方案的参考指标。Objective To investigate the clinical significance of the level of serum lipoprotein associated phospholipase A2 （Lp-PLA2） in patients with liver cirrhosis and hypertension. Methods A total of 292 patients liver cirrhosis and hypertension in the Bayi Hospital Affiliated Nanjing University of Chinese Medcine from March 2016 to April 2017 were selected as subjects.And they were divided into simple liver cirrhosis group （ n =79） and hypertension group （ n =114）,and liver cirrhosis were divided into simple liver cirrhosis group （ n =26）,decompensation group （ n =53）.According to the risk stratification,hypertension patients were divided into classⅠtoⅡ group（ n =27）,and Ⅲ group （ n =87）.A total of 99 cases were decompensated cirrhosis complicated with hypertension,in which there were 55 cases with the high risk in class Ⅲ.The level of Lp-PLA2 was detected by immune scattering turbidimetry.Receiver operating characteristic curve（ROC） was used to analyze the diagnostic value of Lp-PLA2. Results The level of Lp-PLA2 in hypertensive grade Ⅲ group was significantly higher than that of the ⅠtoⅡ group,the difference was statistically significant （ P 〈 0.05 ）.The level of Lp-PLA2 in decompensated cirrhosis group was significantly higher than the compensation group,the difference was statistically significant （ P 〈0.05）.The level of decompensated cirrhosis combined with hypertension in gradeⅢ group was significantly higher than that in the cirrhotic decompensated group,which was also significantly higher than that in the grade Ⅲ group of simple hypertension （ P 〈0.05）.ROC analysis showed that area under the curve was 0.891,the CUT-OFF value was 341.5 ng/mL. Conclusion The level of Lp-PLA2 has a positive effect on the risk of hypertension,which may play a role in the progression of liver cirrhosis.It can also indicate the progression of cirrhosis associated with hypertension.

关 键 词：脂蛋白磷脂酶A2 肝硬化 高血压 预后 

分 类 号：R446.1[医药卫生—诊断学]