摘要
目的研究非ST段抬高型急性冠脉综合征患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平及颈动脉内膜中层厚度(c IMT)对风险分层的评估价值。方法连续选取该院2015年9月—2016年12月因冠心病入住该院心内科的患者142例,其中不稳定型心绞痛组(UAP组)54例、非ST段抬高型心肌梗死组(NSTEMI组)42例、稳定型心绞痛组(SAP组)46例,另选同期非冠心病患者40例为对照组。采用ELISA法检测各组血清Lp-PLA2水平,由该院经验丰富的超声科医师测定c IMT值,比较不同组间水平的差异;分析Lp-PLA2水平、c IMT值与GRACE风险评分及TIMI风险评分的相关性。结果 (1)与对照组及SAP组比较,NSTE-ACS两组患者血清Lp-PLA2水平及c IMT值的差异有统计学意义(P<0.01);(2)血清Lp-PLA2水平与c IMT均呈正相关(r=0.635,P<0.001);(3)血清Lp-PLA2水平与GRACE积分及TIMI积分均呈正相关(r=0.360、P<0.001;r=0.518、P<0.001),c IMT值与GRACE积分及TIMI积分均呈正相关(r=0.190、P=0.036;r=0.252、P=0.005);(4)以NSTE-ACS为因变量,行多因素Logistic回归分析,结果显示Lp-PLA2为NSTE-ACS发生风险的独立预测因子(B=0.048,P<0.001,OR=1.049,95%CI:1.025~1.074)。结论 (1)血清Lp-PLA2水平与c IMT值明显相关;(2)血清Lp-PLA2水平及c IMT值与GRACE风险评分及TIMI风险评分呈正相关,可作为NSTE-ACS患者风险分层的预测指标;(3)血清Lp-PLA2水平是NSTEACS的独立相关因素。
Objective To evaluate the value of serumLipoprotein-associated phospholipase A2（Lp-PLA2） levels and carotid intima-media thickness（c IMT） in the evaluation of risk stratification in patients with non-ST-segment elevation acute coronary syndrome. Methods A total of 142 consecutive patients with coronary artery disease admitted to the hospital from September 2015 to December 2016 were selected. Among them, 54 patients with unstable angina pectoris（UAP group） and non-ST elevation myocardial infarction group（NSTEMI group（42 cases） and stable angina group（SAP group）（46 cases）. 40 non-CHD patients in the same period were selected as the control group. The levels of serumLpPLA2 in each group were detected by ELISA. The c IMT values were determined by an experienced sonographer in this hospital to compare the differences among different groups; the levels of Lp-PLA2, c IMT and GRACE risk scores and TIMI risk scores were analyzed. Results（1） Compared with control group and SAP group, there was significant difference in serumLp-PLA2 level and c IMT value between the two groups of NSTE-ACS patients（P〈0.01）;（2）Both serumLp-PLA2 levels and c IMT were positive（r=0.635, P〈0.001）;（3）SerumLp-PLA2 levels were positively correlated with GRACE scores and TIMI scores（r=0.360, P〈0.001; r=0.518, P〈0.001）, c IMT values and GRACE scores, TIMI scores were positively correlated（r =0.190, P =0.036; r =0.252, P =0.005）;（4） Logistic regression analysis was performed using NSTE-ACS as a dependent variable. The results showed that Lp-PLA2 was NSTE-Independent predictors of risk for ACS（B=0.048, P〈0.001, OR=1.049, 95%CI： 1.025-1.074）. Conclusion（1）SerumLp-PLA2 levels are significantly associated with c IMT values;（2）SerumLp-PLA2 levels and c IMT levels are positively correlated with GRACE risk scores and TIMI risk scores, and can be used as predictors of risk stratification in NSTE-ACS patients.（3） SerumLp-PLA2 levels were independently associated with NSTE-ACS
作者
王丰云
汤建民
季莹莹
杨雁华
宿东升
朱银川
赵一品
来桂棵
王顺利
WANG Feng-yun;TANG Jian-min;JI Ying-ying;YANG Yan-hua;SU Dong-sheng;ZHU Yin-chuan;ZHAO Yi-pin;LAI Gui-ke;WANG Shun-li(Department of Cardiology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, 450014 China)
出处
《系统医学》
2018年第12期51-56,共6页
Systems Medicine
