血清脂蛋白相关磷脂酶A2与缺血修饰白蛋白联合检测对急性ST段抬高型心肌梗死的诊断价值  

Diagnostic value of combined detection of serum lipoprotein-associated phospholipase A2 and ischemic modified albumin in patients with acute ST-segment elevation myocardial infarction

作　　者：杨伏猛[1] 刘倩[1] 王怡练[2] 张黎黎 周新华[3] 孙黎明[2] 滕士阶[1] 姚丽[1] Yang Fumeng;Liu Qian;Wang Yilian;Zhang Lili;Zhou Xinhua;Sun Liming;Teng Shijie;Yao Li(Department of Laboratory,Lianyungang Second People′s Hospital,Lianyungang 222006,China;Department of Cardiovascular Medicine,Lianyungang Second People′s Hospital,Lianyungang 222006,China;Department of Emergency,Lianyungang Second People′s Hospital,Lianyungang 222006,China)

机构地区：[1]连云港市第二人民医院检验科,江苏连云港222006 [2]连云港市第二人民医院心血管内科,江苏连云港222006 [3]连云港市第二人民医院急诊科,江苏连云港222006

出　　处：《中国临床实用医学》2020年第4期18-22,共5页China Clinical Practical Medicine

基　　金：连云港市卫生科研计划项目(201721);蚌埠医学院科研课题(BYKY18178)。

摘　　要：目的:探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)与缺血修饰白蛋白(IMA)联合检测对急性ST段抬高型心肌梗死(STEMI)患者的早期诊断价值。方法:选取2016年1月至2018年12月连云港市第二人民医院急诊科及心血管内科收治的86例STEMI患者为STEMI组,男55例,女31例,年龄(62.5±12.7)岁,年龄范围为33~88岁;另选取同期连云港市第二人民医院体检中心收治的80例健康体检者为健康组,男48例,女32例,年龄(59.2±13.2)岁,年龄范围为25~84岁。采用AU5821全自动生化分析仪检测两组患者血清中的Lp-PLA2、IMA及常规指标,采用ROC曲线分析STEMI的诊断效能,采用二元logistic回归分析对STEMI进行独立危险因素分析。结果:STEMI组的血清Lp-PLA2水平[(648.7±166.2)U/L]、IMA[(76.2±3.3)U/ml]水平高于健康组[(524.0±110.5)U/L、(71.6±3.6)U/ml],差异有统计学意义(P<0.05)。ROC曲线结果显示Lp-PLA2灵敏度为72.1%,曲线下面积为0.743(95%CI:0.666~0.820,P<0.001);IMA灵敏度为73.3%,曲线下面积为0.826(95%CI:0.765~0.888,P<0.001);Lp-PLA2与IMA联合检测灵敏度为91.9%,曲线下面积为0.864(95%CI:0.810~0.917,P<0.001)。logistic回归分析显示,血清Lp-PLA2和IMA是患者发生STEMI的独立危险因素。结论:STEMI患者的血清Lp-PLA2及IMA水平均显著升高,两者联合检测对于STEMI的早期诊断具有重要的临床价值。Objective To investigate the early diagnostic value of combined detection of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and ischemia modified albumin(IMA)in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 86 STEMI patients admitted to the department of Emergency and Cardiovascular,Lianyungang Second People′s Hospital from January 2016 to December 2018 were included in the STEMI group,including 55 males and 31 females(62.5±12.7)years old,ranging from 33 to 88 years old.In addition,80 healthy subjects admitted to the Physical Examination Center of Lianyungang Second People′s Hospital during the same period were selected as the healthy group,including 48 males and 32 females,aged(59.2±13.2)years old,ranging from 25 to 84 years old.Lp-PLA2,IMA and conventional indexes in serum of the two groups were detected by AU5821 automatic biochemical analyzer.ROC curve was used to analyze the diagnostic efficiency of STEMI,and binary logistic regression analysis was used to analyze the independent risk factors of STEMI.Results The serum levels of Lp-PLA2[(648.7±166.2)U/L]and IMA[(76.2±3.3)U/ml]in STEMI group were higher than those in healthy group[(524.0±110.5)U/L,(71.6±3.6)U/ml],and the difference was statistically significant(P<0.05).ROC curve results showed that the sensitivity of Lp-PLA2 was 72.1%,and the area under the curve was 0.743(95%CI:0.666~0.820,P<0.001);the sensitivity of IMA was 73.3%,the area under the curve was 0.826(95%CI:0.765~0.888,P<0.001);the detection sensitivity of Lp-PLA2 and IMA was 91.9%,and the area under the curve was 0.864(95%CI:0.810~0.917,P<0.001).Logistic regression analysis showed that serum Lp-PLA2 and IMA were independent risk factors for STEMI in patients.Conclusion Serum LP-PLA2 and IMA levels are significantly increased in STEMI patients,and combined detection of Lp-PLA2 and IMA is of great clinical value for early diagnosis of STEMI.

关 键 词：急性ST段抬高型心肌梗死 脂蛋白相关磷脂酶A2 缺血修饰白蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]