细胞分布宽度和脂蛋白磷脂酶A2联合检测对冠状动脉性心脏病的预测价值  

Predictive value of combined detection of redcell distribution width and lipoprotein-associated phospholipase A2 in coronary heart disease

作　　者：杨硕 贺志安 刘慧晶 张静 YANG Shuo;HE Zhi′an;LIU Huijing;ZHANG Jing(School of Laboratory Medicine,Xinxiang Medical University,Xinxiang 453003,Henan Province,China;Henan Province Key Laboratory of Immunology and Targeted Drugs,Henan Province Collaborative Innovation Center of Molecular Diagnostics and Medicine Laboratory Technology,Xinxiang 453003,Henan Province,China;Clinical Laboratory,the Fourth Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院医学检验学院,河南新乡453003 [2]河南省免疫与靶向药物重点实验室,河南省分子诊断与医学检验技术协同创新中心,河南新乡453003 [3]新乡医学院第四附属医院检验科,河南新乡453003

出　　处：《新乡医学院学报》2021年第5期463-467,共5页Journal of Xinxiang Medical University

摘　　要：目的分析红细胞分布宽度(RDW)、脂蛋白磷脂酶A2(Lp-PLA2)与冠状动脉病变严重程度的关系,探讨RDW、Lp-PLA2联合检测对冠状动脉性心脏病(CHD)的预测价值。方法选择2018年1月至2019年9月新乡市中心医院收治的因胸痛、胸闷进行冠状动脉造影的患者228例为研究对象。根据冠状动脉造影结果将患者分为CHD组(n=164)和非CHD组(n=64);将CHD组患者根据冠状动脉病变支数再分为单支病变组(n=33)、双支病变组(n=63)和三支病变组(n=68)。分析RDW、Lp-PLA2与Gensini评分的相关性及RDW、Lp-PLA2与CHD的关系,绘制受试者工作特征曲线来评估二者预测CHD的价值。结果CHD组和非CHD组患者的性别、年龄、高血压史、糖尿病史、平均血小板体积等方面比较差异无统计学意义(P>0.05);CHD组患者吸烟者比例及血小板分布宽度、总胆固醇、三酰甘油、低密度脂蛋白(LDL)、葡萄糖(Glu)、尿素、肌酐(Cr)、尿酸、RDW、Lp-PLA2水平均显著高于非CHD组,高密度脂蛋白水平显著低于非CHD组(P<0.05)。RDW、Lp-PLA2与Gensini评分均呈正相关(r=0.698、0.668,P<0.01)。单支病变组和非CHD组患者RDW、LP-PLA2比较差异无统计学意义(P>0.05);双支病变组患者RDW、LP-PLA2均显著高于非CHD组和单支病变组(P<0.05);三支病变组患者RDW、LP-PLA2均显著高于其他3组(P<0.05)。LDL、Glu、Cr、RDW、Lp-PLA2是CHD的危险因素(P<0.05)。RDW联合Lp-PLA2预测CHD的曲线下面积为0.936,灵敏度为83.5%,特异度为90.6%。结论RDW、Lp-PLA2与冠状动脉病变程度呈正相关,二者联合检测对预测CHD具有较高的价值。Objective To analyze the relationship between the red cell distribution width(RDW),lipoprotein-associated phospholipase A2(Lp-PLA2)and the severity of coronary artery lesion,and explore the predictive value of combined detection of RDW,Lp-PLA2 in coronary heart disease(CHD).Methods A total of 228 patients with chest pain or chest tightness underwent coronary angiography(CAG)in the Xinxiang Central Hospital from January 2018 to September 2019 were selected as the research objects.The patients were divided into CHD group(n=164)and non CHD group(n=64)according to the results of CAG;the patients in the CHD group were further divided into single-branch lesion group(n=33),double-branch lesions group(n=63)and three-branch lesions group(n=68)according to the number of the coronary artery lesions branch.The correlation between RDW,Lp-PLA2 and Gensini score,the relationship between RDW,Lp-PLA2 and CHD were analyzed.The receiver operating characteristic curve was drawed for evaluating the value of RDW,Lp-PLA2 in predicting CHD.Results There was no significant difference in gender,age,hypertension history,diabetes history and mean platelet volume between the CHD group and non CHD group(P>0.05).The smoking proportion and platelet distribution width,total cholesterol,triglyceride,low density lipoprotein(LDL),glucose(Glu),urea,creatinine(Cr),uric acid,RDW,Lp-PLA2 levels of patients in the CHD group were significantly higher than those in the non CHD group,and the HDL level was significantly lower than that in the non CHD group(P<0.05).RDW,Lp-PLA2 were positively correlated with Gensini scores(r=0.698,0.668;P<0.01).There was no significant difference in RDW and Lp-PLA2 of patients between the single-branch lesion group and non CHD group(P>0.05);the RDW and Lp-PLA2 of patients in the double-branch lesions group were significantly higher than those in the non CHD group and single-branch lesion group(P<0.05);the RDW and Lp-PLA2 of patients in the three-branch lesions group were significantly higher than those in other three groups(

关 键 词：红细胞分布宽度 脂蛋白磷脂酶A2 冠状动脉性心脏病 GENSINI评分 

分 类 号：R541[医药卫生—心血管疾病]