血清Hcy、ICAM-1、LP-PLA2水平与急性冠脉综合征患者冠脉分层斑块的关系研究  

Study on the Relationship between Serum Hcy,ICAM-1,LP-PLA2 Levels and Coronary Stratified Plaque in Acute Coronary Syndrome Patients

作　　者：陈科新 李峰[1] 姜峰 王勇[2] 戴博 CHEN Ke-xin;LI Feng;JIANG Feng;WANG Yong;DAI Bo(Third Department of Internal Medicine-Cardiovascular,Changsha Third Hospital(Changsha Hospital Affiliated to Hunan University of Traditional Chinese Medicine),Changsha,Hunan,410015,China;Fourth Department of Internal Medicine-Cardiovascular,Changsha Third Hospital(Changsha Hospital Affiliated to Hunan University of Traditional Chinese Medicine),Changsha,Hunan,410015,China)

机构地区：[1]长沙市第三医院(湖南中医药大学附属长沙医院)心血管内科三病室,湖南长沙410015 [2]长沙市第三医院(湖南中医药大学附属长沙医院)心血管内科四病室,湖南长沙410015

出　　处：《现代生物医学进展》2024年第6期1161-1165,1160,共6页Progress in Modern Biomedicine

基　　金：湖南省2021年度自然科学基金项目(2021JJ70123)。

摘　　要：目的:探讨血清同型半胱氨酸(Hcy)、细胞间轴附分子(ICAM-1)、脂蛋白相关磷脂酶A2(LP-PLA2)水平与急性冠脉综合征(ACS)患者冠脉分层斑块的关系。方法:选择2022年1月至2023年1月长沙市第三医院收治的127例ACS患者,根据光学相干断层成像(OCT)结果将患者分为分层斑块组(60例)和非分层斑块组(67例)。检测血清Hcy、ICAM-1、LP-PLA2水平。多因素Logisitc回归分析ACS患者发生冠脉分层斑块的影响因素,受试者工作特征(ROC)分析Hcy、ICAM-1、LP-PLA2预测ACS患者发生冠脉分层斑块的价值。结果:分层斑块组血清Hcy、ICAM-1、LP-PLA2水平高于非分层斑块组(P<0.05)。多因素Logisitc回归分析显示巨噬细胞分级增加,高水平Hcy、高水平ICAM-1、高水平LP-PLA2是ACS患者发生冠脉分层斑块的危险因素(P<0.05)。血清Hcy、ICAM-1、LP-PLA2预测ACS患者发生冠脉分层斑块的曲线下面积为0.833、0.773、0.821,联合预测的曲线下面积为0.944,高于单独预测。结论:ACS冠脉分层斑块患者血清Hcy、ICAM-1、LP-PLA2水平升高,高水平Hcy、ICAM-1、LP-PLA2是ACS患者发生冠脉分层斑块的危险因素。联合血清Hcy、ICAM-1、LP-PLA2对ACS患者发生冠脉分层斑块的预测价值较高。Objective:To investigate the relationship between serum homocysteine(Hcy),intercellular adhesion molecule-1(ICAM-1),lipoprotein-associated phospholipase A2(LP-PLA2)levels and coronary stratified plaque in acute coronary syndrome(ACS)patients.Methods:127 ACS patients admitted to the Changsha Third Hospital from January 2022 to January 2023 were selected,patients were divided into stratified plaque group(60 cases)and non stratified plaque group(67 cases)according to the results of optical coherence tomography(OCT).The levels of serum Hcy,ICAM-1 and LP-PLA2 were detected.The influencing factors of coronary stratified plaques in ACS patients were analyzed by multivariate Logisitc regression analysis.The value of Hcy,ICAM-1 and LP-PLA2 in predicting coronary stratified plaques in ACS patients were analyzed by receiver operating characteristic(ROC)analysis.Results:The levels of serum Hcy,ICAM-1 and LP-PLA2 in stratified plaque group were higher than those in non stratified plaque group(P<0.05).Multivariate Logisitc regression analysis showed that increased macrophage grading,high levels of Hcy,high levels of ICAM-1 and high levels of LP-PLA2 were risk factors for coronary stratified plaques in ACS patients(P<0.05).The area under the curve of serum Hcy,ICAM-1 and LP-PLA2 in predicting the occurrence of coronary stratified plaque in ACS patients was 0.833,0.773 and 0.821 respectively,the area under the curve of combined prediction was 0.944,which was higher than that of single prediction.Conclusion:The levels of serum Hcy,ICAM-1 and LP-PLA2 of coronary stratified plaque in ACS patients are increase,high levels of Hcy,ICAM-1 and LP-PLA2 are risk factors for coronary stratified plaque in ACS patients.The combination of serum Hcy,ICAM-1 and LP-PLA2 has a high predictive value for the occurrence of coronary stratified plaques in ACS patients.

关 键 词：急性冠脉综合征 HCY ICAM-1 LP-PLA2 分层斑块 

分 类 号：R541.4[医药卫生—心血管疾病]