脂蛋白相关磷脂酶A_(2)、脂蛋白a预测冠心病经皮冠状动脉介入治疗术后不良心血管事件的价值  

Value of Lipoprotein-Associated Phospholipase A_(2) and Lipoprotein a in Predicting Adverse Cardiovascular Events After Percutaneous Coronary Intervention in Coronary Heart Disease

作　　者：马威[1] 王跃玲[1] 张新蔚 毛英格 李小全 MA Wei;WANG Yueling;ZHANG Xinwei;MAO Yingge;LI Xiaoquan(Department of Clinical Laboratory,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院医学检验科,河南开封475000

出　　处：《河南医学研究》2021年第29期5388-5390,共3页Henan Medical Research

基　　金：开封市科技发展计划项目(2103019)。

摘　　要：目的探讨脂蛋白相关磷脂酶A_(2)(Lp-PLA_(2))与脂蛋白a[Lp(a)]对冠心病心绞痛急诊经皮冠状动脉介入治疗(PCI)术后不良心血管事件的预测价值。方法回顾性分析河南大学第一附属医院2018年1月至2020年9月收治的475例冠心病心绞痛患者作为研究对象,根据患者术后6个月内是否出现不良心血管事件分为无不良心血管事件组(412例)与不良心血管事件组(63例),通过单因素分析与logistic回归分析评估冠心病心绞痛患者PCI术后不良心血管事件的危险因素,并绘制受试者工作特征曲线(ROC曲线)评估其对不良心血管事件的预测价值。结果与无不良心血管事件组相比,不良心血管事件组患者术前Lp-PLA_(2)、Lp(a)水平升高(P<0.05)。logistic回归分析提示,Lp-PLA_(2)、Lp(a)均为冠心病心绞痛患者PCI术后不良心血管事件的独立危险因素(OR=3.622,95%CI=1.790~3.715,P<0.001;OR=1.344,95%CI=1.121~1.615,P<0.001)。ROC曲线分析提示,Lp-PLA_(2)曲线下面积(AUC)为0.815,敏感度为0.704,特异性为0.856,Lp(a)AUC为0.704,敏感度为0.754,特异性为0.629。结论冠心病心绞痛患者术前Lp-PLA_(2)、Lp(a)水平升高提示PCI术后存在较高的不良心血管事件风险,具有较高的临床应用价值。Objective To investigate the predictive value of lipoprotein-associated phospholipase A_(2)(Lp-PLA_(2))and lipoprotein a[LP(a)]in the adverse cardiovascular events after emergency percutaneous coronary intervention(PCI)for coronary heart disease angina pectoris.Methods Retrospective analysis was performed on 475 cases of coronary heart disease patients with angina pectoris admitted to the First Affiliated Hospital of Henan University from January 2018 to September 2020.According to the occurrence of adverse cardiovascular events within 6 months after surgery,the patients were divided into no adverse cardiovascular events group(412 cases)and adverse cardiovascular events group(63 cases).The risk factors of adverse cardiovascular events in patients with coronary heart disease and angina pectoris after PCI were evaluated by univariate analysis and logistic regression analysis,and the predictive value of these risk factors for adverse cardiovascular events was evaluated by drawing receiver operating characteristic curve(ROC)curve.Results Compared with no adverse cardiovascular events group,the preoperative levels of Lp-PLA_(2)and Lp(a)in the adverse cardiovascular events group were increased(P<0.05).Logistic regression analysis showed that both Lp-PLA_(2)and Lp(a)were independent risk factors for adverse cardiovascular events in coronary heart disease patients with angina pectoris after PCI(OR=3.622,95%CI=1.790~3.715,P<0.001,OR=1.344,95%CI=1.121~1.615,P<0.001).ROC curve analysis indicated that the area under the curve(AUC)of Lp-PLA_(2)was 0.815,the sensitivity was 0.704,the specificity was 0.856,and the sensitivity of Lp-PLA_(2)was 0.754,the specificity was 0.629.Conclusion The elevated levels of Lp-PLA_(2)and Lp(a)in patients with coronary heart disease and angina pectoris preoperatively suggest a higher risk of adverse cardiovascular events after PCI,which has higher clinical application value.

关 键 词：脂蛋白相关磷脂酶A_(2) 脂蛋白A 冠心病心绞痛 经皮冠状动脉介入治疗 不良心血管事件 预测价值 

分 类 号：R446[医药卫生—诊断学]