Lp-PLA2、IMA、Cys-C及FFA联合预测冠心病风险的价值  

The value of lipoprotein-associated phospholipase A2(Lp-PLA2),ischemic modified albumin(IMA),cystatin C(Cys-C),and free fatty acid(FFA)in predicting the risk of coronary heart disease

作　　者：刘冬 李令娟 王卫娟 王宏伟 孙美娜 LIU Dong;LI Ling-juan;WANG Weijuan;无(Department of Cardiovascular Medicine,Fourth People’s Hospital of Langfang City/Affiliated Hospital of Chengde Medical College,Langfang 065700,China;Intervention Department,Fourth People’s Hospital of Langfang City/Affiliated Hospital of Chengde Medical College)

机构地区：[1]廊坊市第四人民医院/承德医学院附属医院心血管内科,河北廊坊065700 [2]廊坊市第四人民医院/承德医学院附属医院介入科

出　　处：《中国实验诊断学》2022年第8期1114-1118,共5页Chinese Journal of Laboratory Diagnosis

基　　金：廊坊市科学技术研究与发展计划,编号:2020013102。

摘　　要：目的 探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、缺血性修饰白蛋白(IMA)、胱抑素C(Cys-C)、游离脂肪酸(FFA)联合预测冠心病风险的价值。方法 110例冠心病患者(冠心病组)分为3个亚组:S组(稳定型心绞痛,33例)、U组(不稳定型心绞痛,38例)、A组(急性心肌梗死,39例)。健康体检者36例为非冠心病组。收集4组一般临床资料,测定4组LP-PLA2、IMA、Cys-C、FFA、血管舒张功能(FMD)、Gensini评分。结果 冠心病组与非冠心病组LP-PLA2、IMA、Cys-C、FFA、FMD、Gensini评分比较,差异有统计学意义(P<0.05),其中LP-PLA2、FFA,非冠心病组<S组<U组<A组,而IMA,非冠心病组>S组>U组>A组。冠心病组各亚组Cys-C高于非冠心病组(P<0.05),U组和A组Cys-C高于S组(P<0.05),U组和A组Cys-C差异无统计学意义(P>0.05)。冠心病组各亚组FMD低于非冠心病组、Gensini评分高于非冠心病组(P<0.05),但各亚组间FMD、Gensini评分差异无统计学意义(P>0.05)。Lp-PLA2、IMA、Cys-C、FFA等4项指标联合检测冠心病各亚型的阳性率均高于单项检测的阳性率(P<0.05)。相关性分析显示,Lp-PLA2、Cys-C、FFA与冠心病各亚型呈正相关(P<0.05),IMA与冠心病各亚型呈负相关(P<0.05)。多因素回归分析结果显示,Lp-PLA2、Cys-C、FFA、Gensini评分为冠心病发生的危险性因素,IMA、FMD为冠心病发生的保护性因素。结论 LP-PLA2、IMA、Cys-C、FFA与冠心病的发生发展有关,4项指标联合检测的诊断价值较高。Objective To discuss the value of lipoprotein-associated phospholipase A2(Lp-PLA2),ischemic modified albumin(IMA),cystatin C(Cys-C),and free fatty acid(FFA)in predicting the risk of coronary heart disease.Methods The 110patients with coronary heart disease(CHD group)were divided into 3subgroups:Group S(stable angina,33cases),Group U(unstable angina,38cases),and Group A(acute myocardial infarction,39cases).36healthy subjects were non-CHD group.General clinical data of 4groups were collected and Lp-PLA2,IMA,Cys-C,FFA,vasodilatation function(FMD)and Gensini scores were determined.Results The difference of Lp-PLA2,IMA,Cys-C,FFA,FMD and Gensini scores between CHD group and non-CHD group was statistically significant(P<0.05),in which Lp-PLA2and FFA were non-CHD grouPgroup S>group U>group A.Cys-C of each sub-group of CHD group was higher than that of non-CHD group(P<0.05),Cys-C of group U and group A was higher than that of group S(P<0.05),and there was no statistically significant difference in Cys-C between group U and group A(P>0.05).FMD of each CHD subgroup were lower than those of the non-CHD group and Gensini scores higher than those of the non-chd group(P<0.05),but there was no statistically significant difference in the FMD and Gensini scores of each subgroup(P>0.05).The positive rates of the combined detection of LPPLA2,IMA,CYS-C and FFA were all higher than those of the single detection(P<0.05).Correlation analysis showed that LP-PLA2,Cys-C and FFA were positively correlated with each subtype of CHD(P<0.05),while IMA was negatively correlated with each subtype of CHD(P<0.05).The results of multivariate regression analysis showed that LpPLA2,Cys-C,FFA and Gensini scores were risk factors for CHD,and IMA and FMD were protective factors for CHD.Conclusion Lp-PLA2,IMA,Cys-C and FFA are related to the occurrence and development of coronary heart disease,the combined detection of four indicators has higher diagnostic value.

关 键 词：冠心病 脂蛋白相关磷脂酶A2 缺血性修饰白蛋白 胱抑素C 游离脂肪酸 

分 类 号：R541.4[医药卫生—心血管疾病]