扩张型心肌病患者心功能与Lp-PLA2表达水平的关系及最佳诊断阈值探讨  

Relationship between Cardiac Function and Lp-PLA2 Expression Level and discussion on the optimal diagnostic Threshold in Patients with dilated Cardiomyopathy

作　　者：郭阳 丁守坤[2] GUO Yang;DING Shou-kun(The First Department of Cardiology,Angang General Hospital for Workers,Anyang 455000,Henan Province,China;The First Department of Cardiology,Henan Provincial People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]安钢职工总医院心内一科,河南安阳455000 [2]河南省人民医院心内一科,河南郑州450000

出　　处：《罕少疾病杂志》2022年第2期46-48,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨扩张型心肌病(DCM)患者心功能与脂蛋白相关磷脂酶A2(Lp-PLA2)表达水平的关系及最佳诊断阈值。方法择取2018年11月至2020年11月经绵阳市中心医院心内科收治的86例DCM患者为观察组,同期选取健康无心脏疾病患者43例为对照组,观察组根据美国纽约心脏病协会(NYHA)心功能分级分作Ⅰ~Ⅱ级组、Ⅲ~Ⅳ级组,收集两组人口学资料、心功能指标、Lp-PLA2表达水平,运用Pearman分析Lp-PLA2表达水平与心功能指标相关性,并以受试者工作特征(ROC)曲线下面积(AUC)探讨最佳诊断阈值。结果观察组Lp-PLA2表达水平相比于对照组更高(P<0.05);除性别、年龄、BMI外,Ⅲ~Ⅳ级组LVEF、FS水平均较Ⅰ~Ⅱ级组更低,LVEDD、Lp-PLA2水平均更高(P<0.05);经Pearman相关性分析,Lp-PLA2表达水平与LVEF、LVEDD、FS存在相关性,与LVEF、FS呈负相关(r1=-0.613,r2=-0.498,P均<0.05),与LVEDD呈正相关(r=0.536,P<0.05);经ROC曲线显示,Lp-PLA2表达水平检测DCM发生时AUC值为0.751,对应最佳截断值为183.25μg/L,此时,敏感度、特异度均较高,分别为75.58%、88.37%。结论扩张型心肌病患者Lp-PLA2呈高表达水平,且心功能分级越高,表达水平越高,与LVEF、LVEDD、FS等主要心功能指标存在相关性,最佳诊断阈值为183.25μg/L,以此来评估DCM发生具有较高诊断价值。Objective To investigate the relationship between cardiac function and lipoprotein-associated phospholipase A2(Lp-PLA2) expression in patients with dilated cardiomyopathy(DCM) and the optimal diagnostic threshold. Methods 86 patients with DCM who were admitted to the department of cardiology of Mianyang Central Hospital between November 2018 and November 2020 were selected as the observation group, and 43 healthy patients without heart disease were included as the control group. The patients in the observation group were divided into I~II group and III~IV group according to the New York Heart Association(NYHA) cardiac function classification. The demographic data, cardiac function indicators and Lp-PLA2 expression level of the two groups were collected, and Pearman analysis was used to analyze the correlation between LpPLA2 expression level and cardiac function indicators. The area under the receiver operating characteristic(ROC) curve(AUC) was used to explore the optimal diagnostic threshold. Results The expression level of Lp-PLA2 in the observation group was higher than that in the control group(P<0.05). In addition to gender, age and BMI, the LVEF and FS of the III~IV group were lower than those of the I~II group, while the LVEDD and Lp-PLA2 were higher(P<0.05). Pearman correlation analysis showed that Lp-PLA2 expression level was correlated with LVEF, LVEDD and FS, and was negatively correlated with LVEF and FS(r1=-0.613, r2=-0.498, all P<0.05), and was positively correlated with LVEDD(r=0.536, P<0.05). ROC curve showed that the AUC value of Lp-PLA2 expression level in detecting the occurrence of DCM was 0.751, and the corresponding optimal cutoff value was 183.25μg/L, and the sensitivity and specificity were both higher at 75.58% and 88.37% respectively. Conclusion Lp-PLA2 is highly expressed among patients with dilated cardiomyopathy, and the higher the cardiac function classification, the higher the expression level. LpPLA2 is correlated with major cardiac function indicators such as LVEF, LVEDD, and FS,

关 键 词：扩张型心肌病 脂蛋白相关磷脂酶A2 心功能 诊断阈值 

分 类 号：R563.3[医药卫生—呼吸系统] R542.2[医药卫生—内科学]