Lp-PLA2的检测在冠状动脉狭窄患者中的临床意义  

The Clinical Significance of the Detection of Lp-PLA2 in Patients with Coronary Artery Stenosis

作　　者：谭明娟[1] 崔薇薇[1] 金玲[1] 潘玉琴[2] TAN Ming-juan;CUI Wei-wei;JIN Ling;PAN Yu-qin(Department of Clinical Laboratory,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Central Laboratory,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)检验科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)中心实验室,江苏南京210006

出　　处：《标记免疫分析与临床》2019年第4期541-545,564,共6页Labeled Immunoassays and Clinical Medicine

基　　金：江苏省青年医学人才(编号:QNRC2016074)

摘　　要：目的探讨血浆脂蛋白相关性磷脂酶A2(LP-PLA2)水平与冠状动脉不同分支狭窄的关系,进一步分析LP-PLA2水平的检测在冠心病患者中的临床意义。方法本次研究共包括268例患者,根据经皮冠状动脉造影术(CAG)结果分组为,对照组(无狭窄),粥样硬化组(主要冠脉分支狭窄≤50%,≥20%),单支病变组(单支狭窄>50%),双支病变组(双支狭窄>50%)和三支病变组(三支或以上狭窄>50%)。采用横断面分析LP-PLA2以及高密度脂蛋白C(HDL-C)、低密度脂蛋白(LDL-C)、总胆固醇(CHOL)、甘油三酯(TG)、载脂蛋白B(ApoB)、载脂蛋白A1(ApoA1)、葡萄糖(GLU)、尿酸(BUA)等生化指标和患者基本情况与冠状动脉狭窄的关系。结果经单因素分析,与对照组比较冠心病传统因素高血压、GLU、HDL-C、ApoA1、BUA或从粥样硬化组,或从单支病变组、双支病变组、三支病变组开始与冠状动脉狭窄相关(P <0.05),而LP-PLA2从单支病变组开始与冠状动脉狭窄显著相关(P <0. 01);通过比较各组间LP-PLA2水平发现,随着冠状动脉病变支数增加Lp-PLA2显著增加(P<0.01),而双支病变组与三支病变组比较其值变化不明显(P>0.05);进一步多元回归分析发现,从单支病变开始LP-PLA2与冠状动脉狭窄独立相关,OR值1.013,95%CI(1.006,1.020),<0.01。结论从冠状动脉单支变化开始LP-PLA2显著增加,并且与冠状动脉狭窄独立相关,因此检测LP-PLA2对冠状动脉狭窄患者病情的评估有重要的临床意义。Objective To investigate the relationship between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) and coronary artery stenosis.Further to analyze the clinical significance of the detection of Lp-PLA2 levels in patients with coronary heart disease.Methods A total of 268 patients were included in this study and grouped according to CAG results,including the control group (no stenosis),the atherosclerosis group (main coronary artery branch stenosis ≤50%,≥20%),the single lesion group (single branch stenosis>50%),the double-branch disease group (double stenosis>50%) and the three-vessel lesion group (three stenosis >50%).Cross-sectional analysis was conducted to evaluate the relationship between the biochemical indicators and the basic status of patients with coronary artery stenosis,including Lp-PLA2 concentrations and high-density lipoprotein C (HDL-C),low-density lipoprotein (LDL-C),total cholesterol (CHOL),triglyceride (TG),and apolipoprotein B (ApoB).Results Univariate analysis showed that hypertension,GLU,HDL,ApoA1and BUA were associated with coronary artery stenosis.(P<0.05),while Lp-PLA2 was significantly associated with coronary artery stenosis from a single disease (P<0.01).By comparing the levels of Lp-PLA2 among groups,it was found that the Lp-PLA2 value increased significantly with the increase of the number of coronary artery lesions (P<0.01).Compared between the double-vessel disease group and the three-vessel disease group,the Lp-PLA2 value did not change significantly(P>0.05).Furthermore,multiple regression analysis showed that Lp-PLA2 was independently associated with coronary artery stenosis from a single-vessel disease with OR value 1.013,and 95% confidence interval(1.006,1.020),(P<0.01).Conclusion The Lp-PLA2 value increases significantly from one coronary artery branch and is independently associated with coronary artery stenosis.Therefore,the detection of Lp-PLA2 value has important clinical significance for the evaluation of coronary artery stenosis.

关 键 词：CAG LP-PLA2 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]