血清血小板活化因子和脂蛋白相关磷脂酶A2对冠状动脉慢血流现象的预测价值分析  

Analysis of predictive value of serum platelet activating factor and lipoprotein-associated phospholipase A2 for coronary slow flow phenomenon

作　　者：师志芳[1] 贾营 张秀敬 谭化 王爱民[1] 赵洁[2] SHI Zhi-fang;JIA Ying;ZHANG Xiu-jing;TAN Hua;WANG Ai-min;ZHAO Jie(Department of Geriatrics,the Third Hospital of Shijiazhuang,Shijiazhuang 050000,China;Department of Cardiology,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]石家庄市第三医院老年医学三科,河北省石家庄市050000 [2]承德医学院附属医院心脏内科

出　　处：《中国心血管病研究》2023年第12期1080-1085,共6页Chinese Journal of Cardiovascular Research

基　　金：河北医学科学课题计划(20210478)。

摘　　要：目的分析血清血小板活化因子(PAF)和脂蛋白相关磷脂酶A2(Lp-PLA2)对冠状动脉慢血流现象的预测价值。方法纳入2020年10月至2022年10月于石家庄市第三医院接受冠状动脉造影时出现冠状动脉慢血流现象的98例患者设为慢血流组,另取冠状动脉血流正常的108例患者设为正常组。所有受检者均接受血清PAF、Lp-PLA2水平检测,对比两组临床资料及实验室指标,绘制受试者工作曲线(ROC)分析血清PAF、Lp-PLA2水平对冠状动脉慢血流现象的预测价值。结果慢血流组高血压占比、血清PAF、Lp-PLA2水平高于正常组[43.88%比28.70%、(113.72±43.65)μg/L比(76.42±15.63)μg/L、(70.16±26.71)μg/L比(41.54±14.68)μg/L,均P<0.05];Logistic回归分析显示,高血压(95%CI 1.090~3.458)、血清PAF(95%CI 1.018~1.044)、Lp-PLA2(95%CI 1.039~1.082)水平是冠状动脉慢血流现象的危险因素(OR>1,P<0.05);经点二列相关性分析,血清PAF、Lp-PLA2水平与冠状动脉慢血流现象呈正相关(r=0.503、0.560,P<0.05);绘制ROC曲线发现,血清PAF、Lp-PLA2水平预测冠状动脉慢血流现象的AUC分别为0.785、0.816、0.854,当cut-off值分别取88.880μg/L、53.095μg/L时可获得最佳预测价值,且联合检测预测的AUC为0.854(95%CI 0.798~0.911),预测价值更高。结论血清PAF、Lp-PLA2水平与冠状动脉慢血流现象密切相关,临床可通过检测二者水平预测冠状动脉慢血流现象。Objective To explore the predictive value of serum platelet activating factor(PAF)and lipoprotein-associated phospholipase A2(Lp-PLA2)for slow coronary flow.Methods A total of 98 patients with slow coronary flow during coronary angiography in Shijiazhuang third Hospital from October 2020 to October 2022 were set as the slow flow group,and another 108 patients with normal coronary flow were set as the normal group.All the subjects were tested for serum PAF and Lp-PLA2 levels.The clinical data and laboratory indexes of the two groups were compared,and a receiver operating curve(ROC)was drawn to analyze the predictive value of serum PAF and Lp-PLA2 levels on slow coronary flow.Results The proportion of hypertension,serum PAFand Lp-PLA2 levels in the slow flow group were higher than those in the normal group[43.88%vs.28.70%,(113.72±43.65)μg/L vs.(76.42±15.63)μg/L,(70.16±26.71)μg/L vs.(41.54±14.68)μg/L,all P<0.05].Logistic regression analysis showed that hypertension(95%CI 1.090-3.458),serum PAF(95%CI 1.018-1.044)and Lp-PLA2(95%CI 1.039-1.082)levels were the risk factors for slow coronary flow(OR>1,P<0.05).In the two-point correlation analysis,both serum PAF and Lp-PLA2 levels positively correlated with slow coronary flow(r=0.503 and 0.560,P<0.05).The ROC curve showed that,the AUCs of serum PAF and Lp-PLA2 levels for the prediction of slow coronary flow were 0.785,0.816,and 0.854,when the cut-off values were 88.880μg/L and 53.095μg/L respectively,the best predictive value was obtained,and the AUC of combined detection was 0.854(95%CI 0.798-0.911),the predictive value was higher.Conclusion Both serum PAF and Lp-PLA2 levels are closely related to the slow coronary flow phenomenon,and the slow coronary flow phenomenon can be predicted clinically by detecting their levels.

关 键 词：冠状动脉慢血流现象 血小板活化因子 脂蛋白相关磷脂酶A2 

分 类 号：R543.3[医药卫生—心血管疾病]