血小板形成相关血清标志物与冠状动脉斑块纤维帽厚度及疾病预后的关系  

Relationship of platelet formation-related serum markers with coronary fibrous cap thickness and outcome in CHD patients

作　　者：石秀芳[1] 牛海军[2] 邓芳 Shi Xiufang;Niu Haijun;Deng Fang(Center of Laboratory Medicine,Bozhou People's Hospital,Bozhou 236800,Anhui Province,China)

机构地区：[1]亳州市人民医院检验中心,236800 [2]亳州市人民医院心内科,236800 [3]中国科技大学第一附属医院检验科

出　　处：《中华老年心脑血管病杂志》2021年第11期1170-1173,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、D-二聚体、可溶性生长刺激表达基因2蛋白(sST2)在不同类型冠心病患者中的表达及其与冠状动脉脂质斑块纤维帽厚度和疾病预后的关系。方法选择冠心病患者270例,分为非ST段抬高型心肌梗死(NSTEMI)组128例、不稳定性心绞痛(UAP)组82例、稳定性心绞痛(SAP)组60例,纳入胸痛入院的非冠心病患者60例为对照组。检测血清Lp-PLA2、D-二聚体、sST2水平。随访1年记录主要不良心血管事件(MACE)。结果与对照组比较,其他3组血清Lp-PLA2、D-二聚体、sST2明显升高(P<0.05)。NSTEMI组Gensini评分、血清Lp-PLA2、D-二聚体、sST2明显高于UAP组和SAP组,且UAP组Gensini评分、血清Lp-PLA2、D-二聚体、sST2明显高于SAP组(P<0.05)。NSTEMI组纤维帽厚度明显低于UAP组和SAP组,且UAP组明显低于SAP组(P<0.05)。血清Lp-PLA2、D-二聚体、sST2预测MACE的ROC曲线下面积(AUC)分别为0.778、0.703、0.745,联合检测的AUC为0.926(95%CI:0.891~0.960)。结论血清Lp-PLA2、D-二聚体、sST2在NSTEMI患者中显著升高,与冠状动脉脂质斑块纤维帽厚度呈负相关,且对预后具有极高的预测价值。Objective To study the relationship of Lp-PLA2,D-dimer and sST2 expressions with coronary fibrous cap thickness and outcome in different CHD patients.Methods Two hundred and seventy CHD patients were divided into non-STEMI group(n=128),UAP group(n=82)and SAP group(n=60)with 60 non-CHD patients served as a control group.The coronary fibrous cap thickness and serum Lp-PLA2,D-dimer,sST2 levels in 4 groups were measured.The patients were followed up for 1 year,during which the incidence of MACE was recorded.Results The Gensini score and serum Lp-PLA2,D-dimer,sST2 levels were significantly higher in non-STEMI group,UAP group and SAP group than in control group(P<0.01)and in UAP group than in SAP group(P<0.05).The coronary fibrous cap thickness was significantly thinner in non-STEMI group than in UAP group and SAP group,and in UAP group than in SAP group(P<0.05).The AUC of serum Lp-PLA2,D-dimer,sST2 levels for predicting MACE in CHD patients was 0.778,0.703 and 0.745 respectively.The AUC of serum Lp-PLA2,D-dimer,sST2 levels measured in combination for predicting MACE in CHD patients was 926(95%CI:0.891-0.960).Conclusion Elevated serum Lp-PLA2,D-dimer and sST2 levels are negaitively related with coronary fibrous cap thickness in non-STEMI patients with an extremely high value for predicting the outcome in CHD patients.

关 键 词：斑块 动脉粥样硬化 急性冠状动脉综合征 1-烷基-2-乙酰甘油磷酸胆碱酯酶 预后 

分 类 号：R541.4[医药卫生—心血管疾病]