冠心病患者血清sdLDL、hs-CRP、MPV/PLT水平与冠状动脉病变严重程度的相关性  

Correlation between serum levels of sdLDL,hs-CRP,MPV/PLT and severity of coronary artery lesions in patients with coronary heart disease

作　　者：冯巧丽 吴佳逢 孟娟[2] 吴强 盛艳华[1] 王军伟 屈晓静 林俊青 高虹 FENG Qiaoli;WU Jiafeng;MENG Juan;WU Qiang;SHENG Yanhua;WANG Junwei;QU Xiaojing;LIN Junqing;GAO Hong(Department of Cardiology,Shenzhen Third People's Hospital,Shenzhen,Gudong 518000,China;Department of Geriatrics,Shenzhen Third People's Hospital,Shenzhen,Gudong 518000,China)

机构地区：[1]深圳市第三人民医院心内科,广东省深圳市518000 [2]深圳市第三人民医院老年科,广东省深圳市518000

出　　处：《中国动脉硬化杂志》2023年第6期491-498,共8页Chinese Journal of Arteriosclerosis

基　　金：深圳市科技计划项目(JCYJ20190809143609762);深圳市第三人民医院院内课题(G2022022)。

摘　　要：[目的]探讨冠心病患者血清小而密低密度脂蛋白(sdLDL)、高敏C反应蛋白(hs-CRP)和平均血小板体积/血小板计数(MPV/PLT)与冠状动脉病变严重程度的相关性。[方法]选取2020年8月—2021年8月在深圳市第三人民医院心内科住院并行冠状动脉造影检查的冠心病患者150例,根据冠状动脉造影结果,分为单支病变组(n=50)、双支病变组(n=50)、多支病变组(n=50);根据临床分型,分为稳定型心绞痛组(SAP组,n=26)、不稳定型心绞痛组(UAP组,n=48)、急性心肌梗死组(AMI组,n=76)。检测各亚组间血清sdLDL、hs-CRP及MPV/PLT水平,分析三者与冠状动脉病变数目及临床分型的相关性,并采用ROC曲线分析其预测冠心病严重程度的效能。[结果]①冠状动脉多支病变组血清sdLDL、hs-CRP及MPV/PLT水平为双支病变组的1.52、1.96及1.16倍(均P<0.05),为单支病变组的2.38、3.32及1.50倍(均P<0.05);双支病变组血清sdLDL、hs-CRP和MPV/PLT水平是单支病变组的1.57、1.69及1.29倍(均P<0.05)。AMI组血清sdLDL和MPV/PLT水平是UAP组的1.39和1.29倍(均P<0.05),是SAP组的1.37和1.38倍(均P<0.05);UAP组血清sdLDL和MPV/PLT水平与SAP组比较差异无统计学意义(P>0.05)。AMI组和UAP组血清hs-CRP水平是SAP组的2.59、1.85倍(均P<0.05),AMI组hs-CRP水平与UAP组比较差异无统计学意义(P>0.05)。②有序Logistic回归分析显示,血清sdLDL、hs-CRP和MPV/PLT水平增高是预测冠心病严重程度的独立危险因素。③Spearman相关性分析显示,血清sdLDL、hs-CRP及MPV/PLT水平不仅与冠状动脉病变数目呈正相关(相关系数分别为0.615、0.569及0.495,均P<0.05),还与冠心病临床分型呈正相关(相关系数分别为0.412、0.400及0.414,均P<0.05)。④ROC曲线显示,血清sdLDL、hs-CRP和MPV/PLT联合检测比单一指标检测预测冠心病严重程度的效能更高。[结论]血清sdLDL、hs-CRP和MPV/PLT水平增高是预测冠心病严重程度的独立危险因素,且与冠状动脉病变数目及Aim To investigate the correlation between small dense low density lipoprotein(sdLDL),high sensitivity C-reactive protein(hs-CRP),mean platelet volume/platelet count(MPV/PLT)and the severity of coronary artery lesions in patients with coronary heart disease.Methods From August 2020 to August 2021,150 patients with coronary heart disease who were hospitalized in the Department of Cardiology of Shenzhen Third People's Hospital and underwent coronary angiography were selected.According to the results of coronary angiography,they were divided into single-vessel lesion group(n=50),double-vessel lesion group(n=50),and multi-vessel lesion group(n=50).According to clinical classification,they were divided into stable angina pectoris group(SAP group,n=26),unstable angina pectoris group(UAP group,n=48),and acute myocardial infarction group(AMI group,n=76).Serum levels of sdLDL,hs-CRP,and MPV/PLT were measured among various subgroups,and their correlation with the number and clinical classification of coronary artery disease was analyzed.The ROC curve was used to analyze their effectiveness in predicting the severity of coronary artery disease.Results①The levels of serum sdLDL,hs-CRP and MPV/PLT in the multi-vessel lesion group were 1.52,1.96 and 1.16 times of those in the double-vessel lesion group(all P<0.05),and 2.38,3.32 and 1.50 times of those in the single-vessel lesion group(all P<0.05).Serum sdLDL,hs-CRP and MPV/PLT levels in the double-vessel lesion group were 1.57,1.69 and 1.29 times higher than those in the single-vessel lesion group(all P<0.05).Serum sdLDL and MPV/PLT levels in AMI group were 1.39 and 1.29 times higher than those in UAP group(all P<0.05),and 1.37 and 1.38 times higher than those in SAP group(all P<0.05).There were no significant differences in serum sdLDL and MPV/PLT levels between UAP group and SAP group(P>0.05).The serum hs-CRP level in AMI group and UAP group was 2.59 and 1.85 times of that in SAP group(both P<0.05),but there was no statistical significance in hs-CRP level between AMI group

关 键 词：冠心病 小而密低密度脂蛋白 高敏C反应蛋白 平均血小板体积 血小板计数 

分 类 号：R5[医药卫生—内科学]