脂蛋白相关磷脂酶A2水平对急性冠脉综合征患者预后的预测价值研究  

The predictive value of lipoprotein associated phospholipase A2 level in prognosis of patients with acute coronary syndrome

作　　者：张恒亮 张培 陈润[1] 李丹丹 汪靖峤 李艳云[1,3] 孙哲臻 汪砚雨 ZHANG Heng-liang;ZHANG Pei;CHEN Run;LI Dan-dan;WANG Jing-qiao;LI Yan-yun;SUN Zhe-zhen;WANG Yan-yu(Department of Cardiology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;Department of Gynecology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China;The Medical School,Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院心内科,河南洛阳471000 [2]河南科技大学第一附属医院妇科,河南洛阳471000 [3]河南科技大学医学院,河南洛阳471000

出　　处：《实用医院临床杂志》2020年第6期212-215,共4页Practical Journal of Clinical Medicine

基　　金：洛阳市医疗卫生科技计划项目资助(编号:1920026A、2030002A)。

摘　　要：目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)水平对急性冠脉综合征患者预后的预测价值。方法2017年6月至2019年12月在河南科技大学第一附属医院心内科住院的急性冠脉综合征患者763例。收集患者的年龄、性别、病史、空腹血清总胆固醇(CHOL)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、尿酸、空腹血糖、心肌酶、脂蛋白相关磷脂酶(Lp-PLA2)等资料,通过COX比例风险模型评估导致急性冠脉综合征患者发生主要心血管事件(MACE)的危险因素。结果共677例患者成功接受有效随访,其中不稳定型心绞痛组患者443例(79.7%)。共有23例(3.4%)患者发生了MACE。Lp-PLA2水平、糖尿病病史、尿酸水平、低血红蛋白分别是导致急性冠脉综合征患者发生MACE的独立危险因素。Lp-PLA2值作为预测急性冠脉综合征患者发生MACE的最佳节点为136.5 ng/ml,其预测MACE发生的敏感性为52.2%,特异性为89%,曲线下面积(AUG)为0.657。结论Lp-PLA2水平升高是导致急性冠脉综合征患者发生MACE的独立危险因素。Lp-PLA2可以作为评估急性冠脉综合征患者预后的潜在生物标志物。Objective To investigate the effect of lipoprotein associated phospholipase A2(Lp-PLA2)level on the prognosis of patients with acute coronary syndrome.Methods A total of 763 patients hospitalized at department of cardiology in our hospital from June 2017 to December 2019 were selected and followed up by telephone.Clinical data such as age,gender,disease history,CHOL,TG,HDL-C,LDL-C,fasting blood glucose,cardiac enzymes and Lp-PLA2 were collected.Cox proportional hazard model was used to evaluate the risk factors of the major adverse cardiovascular events(MACE)in patients with acute coronary syndrome.Results There were 677 patients followed up successfully,including 443 patients(79.7%)in unstable angina group.A total of 23 patients(3.4%)had MACE.Lp-PLA2 level,diabetes history,uric acid level and low hemoglobin were independent risk factors for MACE in patients with acute coronary syndrome.The best cut-off of Lp-PLA2 for predicting MACE in patients with coronary heart disease was 136.5 ng/ml.The sensitivity and specificity of Lp-PLA2 in predicting MACE were 52.2%and 89%,respectively.The area under curve(AUG)of ROC analysis was 0.657(P<0.05).Conclusion The elevated level of Lp-PLA2 is an independent risk factor for MACE in patients with ACS.At the same time,Lp-PLA2 can be used as a potential biomarker to evaluate the prognosis of patients with acute coronary syndrome.

关 键 词：急性冠脉综合征 脂蛋白相关磷脂酶A2 预后 

分 类 号：R541.4[医药卫生—心血管疾病]