血清Lp-PLA2、ICAM-1与2型糖尿病合并冠心病患者Gensini积分的相关性分析  

Correlation analysis of serum Lp-PLA2,ICAM-1 and Gensini score in the type 2 diabetes patients with coronary heart disease

作　　者：段霖 陈璐 王志娟 宋雨航 陈涛 田建会[3] DUAN Lin;CHEN Lu;WANG Zhijuan;SONG Yuhang;CHEN Tao;TIAN Jianhui(Department of Endocrinology,the 970th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army(Weihai Campus),Shandong Province,Weihai264200,China;Department of Cardiovascular Medicine,the 970th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army(Weihai Campus),Shandong Province,Weihai264200,China;Department of Outpatient,Qingdao University Affiliated Hospital,Shandong Province,Qingdao266000,China)

机构地区：[1]中国人民解放军联勤保障部队第九七〇医院(威海院区)内分泌科,山东威海264200 [2]中国人民解放军联勤保障部队第九七〇医院(威海院区)心血管内科,山东威海264200 [3]青岛大学附属医院门诊部,山东青岛266000

出　　处：《中国医药导报》2024年第35期121-125,共5页China Medical Herald

基　　金：中国人民解放军联勤保障部队第九七〇医院科研基金面上资助项目(烟医科[2020]Y010号)。

摘　　要：目的 探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、细胞间黏附分子-1(ICAM-1)与2型糖尿病(T2DM)冠心病患者Gensini积分的相关性。方法 选取2020年5月至2023年4月中国人民解放军联勤保障部队第九七〇医院行冠状动脉造影的T2DM患者318例,根据是否合并冠心病(CHD)将其分为合并组(210例)和未合并组(108例)。比较两组临床资料及Lp-PLA2、ICAM-1的差异,分析Lp-PLA2及ICAM-1水平与T2DM患者Gensini积分的相关性、T2DM合并CHD的影响因素及Lp-PLA2、ICAM-1的预测价值。结果 合并组血清Lp-PLA2、ICAM-1的水平高于未合并组(P<0.01);两组Lp-PLA2、ICAM-1水平与Gensini积分呈正相关(r_s>0,P<0.05)。两组糖尿病病程、糖化血红蛋白(HbA_(1c))、低密度脂蛋白胆固醇(LDL-C)比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,糖尿病病程长及高水平的HbA_(1c)、LDL-C、Lp-PLA2、ICAM-1均是T2DM合并CHD发生的危险因素(P<0.05)。ROC曲线分析结果显示,Lp-PLA2和ICAM-1联合预测的曲线下面积大于LpPLA2、ICAM-1单独预测(Z=2.387、2.135,P<0.05)。结论 T2DM患者Lp-PLA2及ICAM-1水平的升高与Gensini积分呈正相关;Lp-PLA2及ICAM-1水平的监测对T2DM合并CHD的诊断有预测价值。Objective To explore correlation analysis of serum lipoprotein-associated phospholipase A2(Lp-PLA2),intercellular adhesion molecule-1(ICAM-1)and degree of coronary artery stenosis(Gensini score)in the type 2 diabetes patients with coronary heart disease.Methods From May 2020 to April 2023,a total of 318 cases with type 2 diabetic patients undergoing coronary angiograph in the 970th Hospital of Chinese People’s Liberation Army were selected.Patients were divided into merged group(210 cases)and unmerged group(108 cases)based on the presence or absence of coronary heart disease(CHD).The differences in clinical data and levels of serum Lp-PLA2 and ICAM-1 between two groups were compared.The correlation of serum Lp-PLA2 and ICAM-1 levels with Gensini scores,the influencing factors and the predictive value of Lp-PLA2,ICAM-1 in the T2DM combined with CHD were analyzed.Results The levels of serum Lp-PLA2 and ICAM-1 in merged group were higher than those in unmerged group(P<0.01),and Lp-PLA2,ICAM-1 were both positively correlated with Gensini score(rs>0,P<0.05).There were statistically significant differences in diabetes course,glycated haemoglobin A1c(HbA1c),and low density lipoprotein cholesterin(LDL-C)between the two groups(P<0.05).Multivariate logistic regression analysis showed that the long course of diabetes and higher levels of HbA1c,LDL-C,Lp-PLA2,and ICAM-1 were all risk factors of T2DM combined with CHD(P<0.05).Receiver operating characteristic curve showed that the area under the curve of Lp-PLA2 and ICAM-1 combining detection was larger than that of Lp-PLA2 and ICAM-1 alone(Z=2.387,2.135,P<0.05).Conclusion The higher levels of serum LP-PLA2 and ICAM-1 are closely positively correlated with Gensini score,and monitoring of Lp-PLA2 and ICAM-1 has predictive value for T2DM with CHD.

关 键 词：2型糖尿病 冠心病 诊断 脂蛋白相关磷脂酶A2 细胞间黏附分子-1 GENSINI积分 

分 类 号：R587[医药卫生—内分泌]