血清LP-PLA2及ICAM-1对2型糖尿病并发冠心病患者的临床价值  

Clinical value of serum LP-PLA2 and ICAM-1 in type 2 diabetes patients with coronary heart disease

作　　者：段霖 曹金涛 王建强 林俊平 陈涛 田建会[3] DUAN Lin;CAO Juntao;WANG Jianqiang;LIN Junping;CHEN Tao;TIAN Jianhui(Department of Endocrinology,Weihai 970th Hospital,WeiHai,Shandong 264200 China;Department of Cardiology,Weihai 970th Hospital,WeiHai,Shandong 264200 China;Department of Cardiology,the Affiliated Hospital of Qingdao University,Qingdao,Shandong 266003 China)

机构地区：[1]威海第九七〇医院内分泌科,山东威海264200 [2]威海第九七〇医院心内科,山东威海264200 [3]山东省青岛市青岛大学附属医院心内科,山东青岛266003

出　　处：《国际检验医学杂志》2024年第S02期7-11,共5页International Journal of Laboratory Medicine

基　　金：第九七〇医院院级科研基金面上项目(2020Y010)。

摘　　要：目的探讨血清LP-PLA2及ICAM-1对2型糖尿病并发冠心病患者的临床价值。方法选取2020年3月至2023年2月于威海九七〇医院行冠状动脉造影的T2DM患者308例,根据是否并发冠心病(CHD)将其分为并发组(202例)和无并发组(106例),同期65例健康体检人群为对照组。收集研究对象的临床资料,并检测脂蛋白相关磷脂酶A2(LP-PLA2)及细胞间黏附分子-1(ICAM-1)的水平。分析比较各组临床资料及血清。LP-PLA2、ICAM-1水平;多因素Logistic回归分析T2DM并发CHD的影响因素,受试者工作特征(ROC)曲线分析LP-PLA2及ICAM-1对T2DM并发CHD的预测价值。结果并发组血清LP-PLA2、ICAM-1的水平均高于无并发组(P<0.01);无并发组血清LP-PLA2、ICAM-1的水平高于对照组(P<0.01)。多因素Logistic回归分析结果显示,LP-PLA2、ICAM-1、LDL-C、HbA1c水平的升高及长糖尿病病程是糖尿病并发冠心病发生的独立危险因素(均P<0.05),ROC曲线分析结果显示,LP-PLA2、ICAM-1联合预测T2DM患者并发CHD的曲线下面积大于二者单独预测(0.862比0.799、0825,均P<0.05)。结论T2DM患者LPPLA2及ICAM-1的高水平是CHD发生的危险因素,可作为监测T2DM并发CHD诊治的辅助指标。Objective To investigate the clinical value of serum lipoprotein-associated phospholipase A2(LP-PLA2)and intercellular adhesion molecule-1(ICAM-1)in type 2 diabetes(T2DM)patients with coronary heart disease.Methods A total of 308 T2DM patients who underwent coronary angiography at Weihai 970 Hospital from March 2020 to February 2023 were selected and divided into a concurrent group(202 cases)and a non concurrent group(106 cases)based on whether they had concurrent coronary heart disease(CHD).During the same period,65 healthy individuals who underwent physical examinations were selected as the control group.Clinical data of the research subjects were collected and the levels of LP-PLA2 and ICAM-1 were detected.The clinical data and serum levels of LP-PLA2 and ICAM-1 in each group were analyzed and compared.Multivariate Logistic regression was used to analyze the influencing factors of T2DM complicated with CHD,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of LP-PLA2 and ICAM-1 for T2DM complicated with CHD.Results The levels of LP-PLA2 and ICAM-1 in the concurrent group were higher than those in the non concurrent group(both P<0.01).The levels of serum LPPLA2 and ICAM-1 in the non concurrent group were higher than those in the control group(both P<0.01).Multivariate logistic regression analysis showed that the increased levels of LP-PLA2,ICAM-1,LDL-C,HbA1c and the long course of diabetes were independent risk factors for diabetes complicated with coronary heart disease(P<0.05).The ROC curve analysis results showed that the combined prediction of LP-PLA2 and ICAM-1 for CHD in T2DM patients had a larger area under the curve than their individual predictions(0.862 vs.0.799,0825,P<0.05).Conclusion The high levels of LP-PLA2 and ICAM-1 in T2DM patients are risk factors for CHD and can serve as auxiliary indicators for monitoring the diagnosis and treatment of CHD in T2DM patients.

关 键 词：2型糖尿病 冠心病 脂蛋白相关磷脂酶A2 细胞间黏附分子-1 

分 类 号：R587.1[医药卫生—内分泌]