血清脂蛋白相关磷脂酶A2水平对不同冠脉病变程度的心力衰竭患者心功能的评价  

Evaluation of serum lipoprotein⁃associated phospholipase A2 level on cardiac function in heart failure patients with different degrees of coronary artery disease

作　　者：杜继冉 焦梅 齐永升 DU Jiran;JIAO Mei;QI Yongsheng(Department of Internal Medicine,Funan County Hospital of Traditional Chinese Medicine,Funan,Anhui,China,236300)

机构地区：[1]阜南中医院内二科,安徽阜南236300

出　　处：《分子诊断与治疗杂志》2023年第6期972-976,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省医学会急诊临床研究项目(ky2018009)。

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平对不同冠脉病变程度的心力衰竭患者心功能的评价价值。方法选取阜南中医院2020年3月至2022年3月收治的196例心力衰竭患者作为研究对象,按照冠脉病变程度将患者分为轻度组(Gensini评分<30分,n=52)、中度组(30分≤Gensini评分≤60分,n=95)和重度组(Gensini评分>60分n=49),每组再以纽约心脏病学会(NYHA)心功能分级分为良好组(Ⅱ级)和不良组(Ⅲ~Ⅳ级)。比较各组一般资料以及Lp-PLA2水平,采用Spearman相关性分析Lp-PLA2与不同冠脉病变程度心力衰竭患者的心功能的相关性。采用二分类Logistic回归分析不同冠脉病变严重程度心功能不良的独立影响因素,采用受试者工作曲线(ROC)分析不同冠脉病变程度心力衰竭患者Lp-PLA2与心功能的关系。结果性别、家族史、吸烟史、NYHA心功能分级Ⅲ~Ⅳ级比例和血清Lp-PLA2水平比为:轻度组<中度组<重度组,差异具有统计学意义(χ^(2)=110.101、7.300、20.481、14.631,F=256.042,P<0.05)。轻度组的良好组和不良组的Lp-PLA2水平比较,差异无统计学意义(t=1.850,P>0.05)。中度组和重度组的不良组的Lp-PLA2水平均明显高于良好组,差异具有统计学意义(t=11.974、4.335,P<0.05)。Spearman相关性分析显示,中度和重度冠脉病变心力衰竭患者的Lp-PLA2水平与患者的心功能不良呈正相关(P<0.05)。二元Logistic回归分析显示,Lp-PLA2是中度和重度冠脉病变患者心功能不良的独立危险因素(P<0.05)。ROC曲线显示,Lp-PLA2预测中度冠脉病变患者和重度冠脉病变患者的心功能不良的曲线下面积(AUC)为0.977、0.871。结论Lp-PLA2对中度和重度冠脉病变患者的心功能不良有一定的预测价值。Objective To investigate the evaluation value of serum lipoprotein⁃associated phospho⁃lipase A2(Lp⁃PLA2)levels on cardiac function in patients with heart failure with different degrees of coronary artery disease.Methods A total of 196 patients with heart failure admitted to Funan Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the research objects.According to the de⁃gree of coronary artery lesions,the patients were divided into the mild group(Gensini score<30,n=52)and the moderate group(30≤Gensini score≤60).n=95)and the severe group(Gensini score>60 n=49).Each group was further divided into the good group(gradeⅡ)and the poor group(gradeⅢ~Ⅳ)according to the New York College of Cardiology(NYHA)cardiac function scale.General data and Lp⁃PLA2 levels of each group were compared,and Spearman correlation was used to analyze the correlation between Lp⁃PLA2 and car⁃diac function in patients with heart failure with different degrees of coronary artery lesions.Binary Logistic regression was used to analyze the independent influencing factors of cardiac dysfunction with different severity of coronary artery disease,and the receiver operating curve(ROC)was used to analyze the relationship between Lp⁃PLA2 and cardiac function in patients with heart failure with different severity of coronary artery disease.Results Gender,family history,smoking history,NYHA heart function gradeⅢ~Ⅳratio and serum Lp⁃PLA2 ratio were mild group<moderate group<severe group,the differences were statistically significant(χ^(2)=110.101,7.300,20.481,14.631,F=256.042,P<0.05).There was no significant difference in Lp⁃PLA2 levels between the good and the poor groups in the mild group(t=1.850,P>0.05).The levels of Lp⁃PLA2 in the mod⁃erate and severe groups were significantly higher than those in the good group,with statistical significance(t=11.974,4.335,P<0.05).Spearman correlation analysis showed that Lp⁃PLA2 levels were positively correlated with cardiac dysfunction in pat

关 键 词：血清脂蛋白相关磷脂酶A2 冠脉病变程度 心力衰竭 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]