CYP2C19基因多态性联合血浆Lp-PLA2对多部位动脉硬化的预测价值  

Predictive value of CYP2C19 genetic polymorphism combined with plasma Lp-PLA2 for multiple sites of arteriosclerosis

作　　者：徐舟 罗伟文[1] 邹新辉[1] XU Zhou;LUO Weiwen;ZOU Xinhui(Department of Critical Care Medicine,Meizhou People′s Hospital,Meizhou,Guangdong 514000,China)

机构地区：[1]广东省梅州市人民医院重症医学四科,广东梅州514000

出　　处：《检验医学与临床》2025年第5期640-644,650,共6页Laboratory Medicine and Clinic

基　　金：广东省医学科学技术研究基金项目(B2023335)。

摘　　要：目的分析CYP2C19基因多态性联合血浆脂蛋白相关磷脂酶A2(Lp-PLA2)对多部位动脉硬化的预测价值。方法采用回顾性队列研究,从该院电子病历系统中筛选出2022年2月至2023年12月收治496例动脉硬化患者临床资料,根据动脉硬化发生部位数量分为对照组(233例,单一部位动脉硬化)和研究组(263例,多部位动脉硬化)。比较2组CYP2C19基因多态性、血浆Lp-PLA2水平及其他相关资料的差异。采用受试者工作特征(ROC)曲线分析CYP2C19基因多态性联合血浆Lp-PLA2检测对多部位动脉硬化的预测价值。采用多因素Logistic回归分析多部位动脉硬化发生的危险因素。结果2组年龄、高血压史、糖尿病史、冠心病史、CYP2C19基因型分布情况比较,差异均有统计学意义(P<0.05)。研究组血浆Lp-PLA2水平高于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,有糖尿病史、有冠心病史、血浆Lp-PLA2>401.66μg/mL及CYP2C19基因型为*2/*2是多部位动脉硬化发生的危险因素(P<0.05)。构建多部位动脉硬化风险列线图预测模型显示,偏差校正曲线与实际曲线、理想曲线基本吻合(Hosmer-Lemeshow检验χ^(2)=6.700,P=0.569)。ROC曲线分析结果显示,该模型预测多部位动脉硬化的曲线下面积为0.714(95%CI:0.669~0.759)。结论血浆Lp-PLA2>401.66μg/mL、CYP2C19基因型为*2/*2可能是多部位动脉粥样硬化发生的危险因素,2项指标联合检测对多部位动脉硬化具有一定预测价值。Objective To analyze the predictive value of CYP2C19 gene polymorphism combined with plasma lipoprotein-associated phospholipase A2(Lp-PLA2)for multiple sites of atherosclerosis.Methods A retrospective cohort study was used to select the clinical data of 496 patients with arteriosclerosis admitted to the hospital from February 2022 to December 2023 from the electronic medical record system.According to the number of arteriosclerosis sites,they were divided into control group(233 cases,single site of arteriosclerosis)and study group(263 cases,multiple sites of arteriosclerosis).The differences of CYP2C19 gene polymorphism,plasma Lp-PLA2 level and other related data between the two groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CYP2C19 gene polymorphism combined with plasma Lp-PLA2 detection for multiple sites of arteriosclerosis.Multivariate Logistic regression was used to analyze the risk factors of multi-site arteriosclerosis.Results There were significant differences in age,history of hypertension,diabetes,coronary heart disease,and CYP2C19 genotype distribution between the 2 groups(P<0.05).The plasma Lp-PLA2 level of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that a history of diabetes,a history of coronary heart disease,plasma Lp-PLA2>401.66μg/mL and CYP2C19 genotype*2/*2 were risk factors for multiple sites of arteriosclerosis(P<0.05).The construction of multi-site arteriosclerosis risk nomogram prediction model showed that the deviation correction curve was basically consistent with the actual curve and the ideal curve(Hosmer-Lemeshow testχ^(2)=6.700,P=0.569).ROC curve analysis showed that the area under the curve of the model for predicting multiple sites of arteriosclerosis was 0.714(95%CI:0.669-0.759).Conclusion Plasma Lp-PLA2>401.66μg/mL and CYP2C19 genotype*2/*2 may be risk factors for multiple sites of atherosclerosis,

关 键 词：多部位动脉硬化 CYP2C19基因多态性 脂蛋白相关磷脂酶A2 危险因素 预测价值 

分 类 号：R543.5[医药卫生—心血管疾病] R446.1[医药卫生—内科学]