老年冠心病患者血清一氧化氮、脂蛋白相关磷脂酶A2、同型半胱氨酸水平与冠状动脉Gensini积分的相关性分析  

Analysis of correlation between levels of serum nitric oxide,lipoprotein-associated phospholipase A2 and homocysteine and coronary artery Gensini score in elderly patients with coronary artery heart disease

作　　者：崔倩卫[1] 武冬[1] 徐晶[1] Cui Qianwei;Wu Dong;Xu Jing(Department of Cardiology,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院心血管内科,西安710068

出　　处：《中国医学前沿杂志（电子版）》2021年第1期89-93,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析老年冠心病患者血清一氧化氮(nitric oxide,NO)、脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、同型半胱氨酸(homocysteine,Hcy)水平与冠状动脉Gensini积分的相关性。方法回顾性分析2017年2月至2019年3月陕西省人民医院收治的116例老年冠心病患者的临床资料。根据冠状动脉Gensini积分分为低分组(1~30分,40例)、中分组(31~60分,39例)和高分组(>60分,37例)。另选取该院同期老年健康体检者31例的临床资料作为对照。比较四组研究对象血清NO、Lp-PLA2、Hcy水平差异,采用Pearson相关系数分析血清NO、Lp-PLA2、Hcy水平与冠状动脉Gensini积分的相关性,采用受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)评估血清NO、Lp-PLA2、Hcy水平对冠状动脉重度狭窄的诊断价值,并分析不同冠心病类型患者Gensini积分及血清NO、Lp-PLA2、Hcy水平变化情况。结果四组研究对象血清NO水平依次为:对照组>低分组>中分组>高分组(P<0.05);血清Lp-PLA2和Hcy水平均依次为:对照组<低分组<中分组<高分组(均P<0.05)。血清NO水平与冠状动脉Gensini积分呈显著负相关(r=-0.324,P<0.05),血清Lp-PLA2和Hcy水平与冠状动脉Gensini积分均呈显著正相关(r=0.411、0.384,均P<0.05)。血清NO、Lp-PLA2、Hcy水平对冠状动脉重度狭窄均具有较高诊断价值,其曲线下面积分别为0.923、0.939、0.927,截断值分别为29.760、337.140、19.575。不同冠心病类型患者冠状动脉Gensini积分及血清Lp-PLA2、Hcy水平均为:稳定型心绞痛<不稳定型心绞痛<急性心肌梗死(均P<0.05),血清NO水平为稳定型心绞痛>不稳定型心绞痛>急性心肌梗死(P<0.05)。结论血清NO、Lp-PLA2、Hcy水平与老年冠心病患者冠状动脉狭窄严重程度密切相关,且其对预测患者病情进展亦具有重要作用。Objective To analyze the correlation between levels of serum nitric oxide(NO),lipoprotein-associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)and coronary artery Gensini score in elderly patients with coronary artery heart disease(CHD).Method The clinical data of 116 elderly patients with CHD treated in Shaanxi Provincial People's Hospital from February 2017 to March 2019 were analyzed retrospectively.According to the coronary artery Gensini score,the patients were divided into low score group(1~30 points,n=40),middle score group(31~60 points,n=39)and high score group(>60 points,n=37).In addition,the clinical data of 31 elderly healthy subjects who underwent physical examination during the same period were selected as control group.The levels of serum NO,Lp-PLA2 and Hcy were compared among the four groups,and the correlation between levels of serum NO,Lp-PLA2 and Hcy and coronary artery Gensini score was analyzed by Pearson correlation coefficient.The diagnostic value of serum NO,Lp-PLA2 and Hcy levels on severe coronary artery stenosis was evaluated by receiver operator characteristic curve(ROC curve).The changes of Gensini score and serum NO,Lp-PLA2 and Hcy levels in patients with different types of CHD were analyzed.Result Serum NO levels of the four groups were as follows:control group>low score group>middle score group>high score group(P<0.05),and the levels of serum Lp-PLA2 and Hcy were all as follows:control group<low score group<middle score group<high score group(all P<0.05).Serum NO level was negatively correlated with coronary artery Gensini score(r=-0.324,P<0.05),while serum Lp-PLA2 and Hcy levels were positively correlated with coronary artery Gensini score (r = 0.411, 0.384, all P < 0.05). The levels of serum NO, Lp-PLA2 and Hcy had high diagnostic value on severe coronaryartery stenosis, and the areas under the curves were 0.923, 0.939 and 0.927, and the cut-off values were 29.760, 337.140 and 19.575respectively. The coronary artery Gensini score and serum Lp-PLA2 and Hcy levels in patients wi

关 键 词：冠心病 老年 GENSINI积分 一氧化氮 脂蛋白相关磷脂酶A2 同型半胱氨酸 

分 类 号：R541.4[医药卫生—心血管疾病]