脂蛋白磷脂酶A2联合系统免疫炎性指数对2型糖尿病患者冠心病风险的预测价值  

Predictive value of lipoprotein-associated phospholipase A2 combine with systemic immuneinflammation index for coronary heart disease risk in patients with type 2 diabetes mellitus

作　　者：魏世刚 汪亚丽[2] 彭倩 王方芳[1] Wei Shigang;Wang Yali;Peng Qian;Wang Fangfang(Department of Clinical Laboratory,the People's Hospital of Pengzhou,Pengzhou 611930,China;Department of Clinical Laboratory,the People's Hospital of Deyang,Deyang 618000,China)

机构地区：[1]彭州市人民医院检验科,彭州611930 [2]德阳市人民医院检验科,德阳618000

出　　处：《中国医师进修杂志》2023年第9期838-843,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:探讨脂蛋白磷脂酶A2(Lp-PLA2)联合系统免疫炎性指数(SII)对2型糖尿病患者冠心病风险的预测价值。方法:采用前瞻性研究的方法,选取2018年5月至2021年5月彭州市人民医院2型糖尿病患者130例。患者均行冠状动脉造影检查,其中合并冠心病49例(冠心病组),未合并冠心病81例(非冠心病组)。记录患者临床资料,检测白细胞、单核细胞、血小板、中性粒细胞、淋巴细胞、血红蛋白、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖、C反应蛋白(CRP)、糖化血红蛋白和Lp-PLA2;计算SII。采用多因素Logistic回归分析影响2型糖尿病患者发生冠心病的独立危险因素,利用受试者工作特征(ROC)曲线评价Lp-PLA2和SII预测2型糖尿病患者发生冠心病的效能。结果:两组白细胞、血红蛋白、TC、TG、LDL-C、空腹血糖、糖化血红蛋白和CRP比较差异无统计学意义( P>0.05);冠心病组单核细胞、血小板、中性粒细胞、Lp-PLA2和SII明显高于非冠心病组[(0.55 ± 0.22)×10^(9)/L比(0.40 ± 0.11)×10^(9)/L、(227.84 ± 40.76)×10^(9)/L比(205.81 ± 39.04)×10^(9)/L、(6.78 ± 1.45)×10^(9)/L比(6.30 ± 1.18)×10^(9)/L、(240.67 ± 41.48)μg/L比(214.83 ± 36.35)μg/L和1 245.76 ± 383.08比929.84 ± 260.27],淋巴细胞和HDL-C明显低于非冠心病组[(1.26 ± 0.17)×10^(9)/L比(1.41 ± 0.19)×10^(9)/L和(1.15 ± 0.14)mmol/L比(1.23 ± 0.21)mmol/L],差异有统计学意义( P<0.01或<0.05)。多因素Logistic回归分析结果显示,单核细胞、HDL-C、Lp-PLA2和SII是影响2型糖尿病发生冠心病的独立危险因素( OR = 1.812、1.013、1.013和2.004,95% CI 4.430~6.801、0.992~1.013、1.001~1.026和0.004~0.855, P<0.01或<0.05)。ROC曲线分析显示,Lp-PLA2联合SII预测2型糖尿病患者发生冠心病的曲线下面积明显高于单指标Lp-PLA2和SII[0.783(95% CI 0.702~0.851)比0.681(95% CI 0.593~0.760)和0.744(95% CI 0.660~0.816)],差异有统�Objective To explore the predictive value of lipoprotein-associated phospholipase A2(Lp-PLA2)combined with systemic immune-inflammation index(SI)for coronary heart disease risk in patients with type 2 diabetes mellitus.Methods A prospective study was performed,130 patients with type 2 diabetes mellitus from May 2018 to May 2021 in the People's Hospital of Pengzhou were selected.All patients underwent coronary angiography examination,and 49 cases were complicated with coronary heart disease(coronary heart disease group),81 cases were not complicated with coronary heart disease(non-coronary heart disease group).The clinical data were recorded;the white blood cell,monocyte,platelet,neutrophils,lymphocyte,hemoglobin,total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood glucose,C-reactive protein(CRP),glycated hemoglobin and Lp-PLA2 were detected;and the SII was calculated.Multivariate Logistic regression analysis was used to analyze the independent risk factors of coronary heart disease in patients with type 2 diabetes mellitus;the efficacy of Lp-PLA2 and SII in predicting the coronary heart disease in patients with type 2 diabetes mellitus was evaluated using the receiver operating characteristics(ROC)curve.Results There were no statistical differences in white blood cell,hemoglobin,TC,TG,LDL-C,fasting blood glucose,glycated hemoglobin and CRP between two groups(P>0.05);the monocyte,platelet,neutrophils,Lp-PLA2 and SI in coronary heart disease group were significantly higher than those in the non-coronary heart disease group:(0.55±0.22)×10^(9)/L vs.(0.40±0.11)×10^(9)/L,(227.84±40.76)×10^(9)/L vs.(205.81±39.04)×10^(9)/L,(6.78±1.45)×10^(9)/Lvs.(6.30±1.18)×10^(9)/L,(240.67±41.48)μg/Lvs.(214.83±36.35)μg/L and 1245.76±383.08 vs.929.84±260.27,the lymphocyte and HDL-C were significantly lower than those in the non-coronary heart disease group:(1.26±0.17)×10^(9)/L vs.(1.41±0.19)×10^(9)/L and(1.15±0.14)mmol/L vs.(1

关 键 词：糖尿病 2型 冠状动脉疾病 预测 脂蛋白磷脂酶A2 系统免疫炎性指数 

分 类 号：R587.2[医药卫生—内分泌] R541.4[医药卫生—内科学]