血清Lp-PLA2、血小板聚集率、平均血小板体积/血小板计数比值与老年冠心病患者主要不良心血管事件的相关性分析  

Correlations between serum Lp⁃PLA2,platelet aggregation rate,the ratio of mean platelet volume to platelet count and adverse cardiovascular events in elderly patients with coronary heart disease

作　　者：张翥 祁建成[1] 陶亮亮 范修才[1] 吴景盛 Zhang Zhu;Qi Jiancheng;Tao Liangiang;Fan Xiucai;Wu Jingsheng(Department of Cardiovasology,Jianhu Hospital Affiliated to Nantong University,Nantong 224700,China)

机构地区：[1]南通大学附属建湖医院心血管内科,江苏南通224700

出　　处：《海军医学杂志》2023年第12期1248-1253,共6页Journal of Navy Medicine

基　　金：江苏省盐城市科技计划项目(YK2021082);江苏省科技公关计划项目(2019JCZ0628)。

摘　　要：目的探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、血小板聚集率(PAG)、平均血小板体积/血小板计数比值(MPV/PLT)与老年冠心病(CHD)患者主要不良心血管事件(MACE)的相关性。方法回顾性收集南通大学附属建湖医院2020年8月至2021年9月收治的162例老年CHD患者临床资料,所有患者均予阿司匹林口服治疗并接受1年随访,记录患者1年内出现MACE情况,根据是否出现MACE将患者分为发生组(30例)和未发生组(132例),比较2组患者入院时血清Lp-PLA2、PAG、MPV/PLT,采用Logistic回归分析其与老年CHD患者MACE的关系,用受试者操作特征(ROC)曲线评估患者入院时血清Lp-PLA2、PAG、MPV/PLT及3项联合预测1年内出现MACE的价值。结果发生组年龄≥75岁占比、合并高血压占比显著高于未发生组,差异均有统计学意义(P<0.05)。与未发生组比较,发生组患者血清Lp-PLA2、PAG、MPV/PLT水平更高,差异均有统计学意义(P<0.05)。Logistic回归分析显示,合并高血压、Lp-PLA2、PAG、MPV/PLT是影响老年CHD患者MACE发生的因素(P<0.05)。ROC曲线结果显示,Lp-PLA2、PAG、MPV/PLT、3项联合预测老年CHD患者MACE的曲线下面积(AUC)分别为0.832、0.817、0.841、0.939。结论Lp-PLA2、PAG、MPV/PLT过表达与老年CHD患者发生MACE有紧密联系,住院期间可通过检测Lp-PLA2、PAG、MPV/PLT水平评估MACE发生风险,及时进行临床干预。Objective To investigate the correlations between lipoprotein associated phospholipase A2(Lp-PLA2),platelet aggregation rate(PAG),the ratio of mean platelet volume to platelet count(MPV/PLT)and major adverse cardiovascular events(MACE)in elderly patients with coronary heart disease(CHD).Methods The clinical data of 162 elderly patients with CHD admitted to Jianhu Hospital affiliated to Nantong University from August 2020 to September 2021 were collected retrospectively.All the patients were treated with aspirin orally and followed up for 1 year.The development of MACE within 1 year was recorded.MACE occurred in 30 patients(development group)and the other 132 patients without MACE were assigned to non-development group.Serum Lp-PLA2,PAG,and MPV/PLT were compared between the 2 groups at admission.Logistic regression was used to analyze the relationship between these parameters and MACE in elderly CHD patients.Receiver operating character(ROC)curve was used to evaluate the value of serum Lp-PLA2,PAG,MPV/PLT alone and jointly at admission in predicting MACE within 1 year.Results The proportions of patients with age≥75 years and hypertension in the development group were significantly higher than those in the non-development group(P<0.05).Serum Lp-PLA2,PAG,MPV/PLT in the development group were also significantly higher than those in the non-development group(P<0.05).Binary logistic regression analysis showed that hypertension,Lp-PLA2,PAG,and MPV/PLT were influence factors of MACE in elderly CHD patients(P<0.05).ROC curve results showed that the area under curve(AUC)values of Lp-PLA2,PAG,MPV/PLT alone or jointly were 0.832,0.817,0.841 and 0.939 in predicting MACE in elderly CHD patients.Conclusion Overexpression of Lp-PLA2,PAG and MPV/PLT are closely related to the development of MACE in elderly CHD patients.During hospitalization,the risk of MACE can be assessed by detecting Lp-PLA2,PAG,and MPV/PLT,and timely clinical intervention can be carried out.

关 键 词：脂蛋白相关磷脂酶A2 血小板聚集率 平均血小板体积/血小板计数比值 冠心病 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]