摘要
目的分析脂蛋白相关磷脂酶A2(Lp-PLA2)对冠心病患者反杓型血压及冠状动脉重度狭窄的诊断价值。方法选取2016年4月-2018年12月在汕头大学附属粤北人民医院心血管内科住院的冠心病患者199例,根据冠状动脉病变支数分为单支病变组83例、双支病变组62例、三支病变组54例。比较三组患者一般资料、实验室检查指标、血压昼夜节律及Gensini积分;变量间的相关性采用Pearson相关分析及偏相关分析;绘制ROC曲线以评价Lp-PLA2对冠心病患者反杓型血压及冠状动脉重度狭窄的诊断价值。结果(1)三组患者性别、年龄、高血压分级、2型糖尿病发生情况、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)、脂蛋白a〔LP(a)〕、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)比较,差异无统计学意义(P>0.05);三组患者体质指数(BMI)、LpPLA2、血压昼夜节律及Gensini积分比较,差异有统计学意义(P<0.05)。(2)Pearson相关分析及偏相关分析结果显示,Lp-PLA2与冠心病患者高血压分级(r=0.26)、BMI(r=0.24)、hs-CRP(r=0.40)、血压昼夜节律(r=0.30)及Gensini积分(r=0.28)均呈正相关(P<0.05)。(3)Lp-PLA2诊断冠心病患者反杓型血压的曲线下面积(AUC)为0.651、最佳临界值为301.5μg/L,诊断冠心病患者冠状动脉重度狭窄的AUC为0.593、最佳临界值为225.0μg/L。结论 Lp-PLA2与冠心病患者高血压分级、BMI、hs-CRP、血压昼夜节律及Gensini积分呈正相关,可在一定程度上反映冠心病患者血压昼夜节律变化及冠状动脉病变严重程度,且对冠心病患者反杓型血压及冠状动脉重度狭窄有一定诊断价值。
Objective To analyze the diagnostic value of Lp-PLA2 on reverse-dipper blood pressure and severe stenosis of coronary artery in patients with coronary heart disease(CHD).Methods From April 2016 to December 2018,a total of 199 patients with CHD were selected in Yue Bei People’s Hospital Affiliated to Shantou University,and they were divided into A group(with single vessel stenosis,n=83),B group(with double-vessel stenosis,n=62)and C group(with triple-vessel stenosis,n=62)according to the number of stenosed coronary arteries.General information,laboratory examination results,circadian rhythm of blood pressure and Gensini score were compared in the three groups;Pearson and partial correlation analysis were used to analyze the correlations between variables;ROC curve was drawn evaluate the diagnostic value of Lp-PLA2 on reverse-dipper blood pressure and severe stenosis of coronary artery in patients with CHD.Results(1)No statistically significant difference of gender,age,hypertension grades,incidence of type 2 diabetes mellitus,TC,TG,HDL-C,LDL-C,ApoA,ApoB,Lp(a),FBG,HbA1 c or hs-CRP was found in the three groups(P>0.05),while there was statistically significantly difference in BMI,Lp-PLA2,circadian rhythm of blood pressure and Gensini score in the three groups,respectively(P<0.05).(2)Pearson and partial correlation analysis results showed that,Lp-PLA2 was statistically significantly correlated positively with hypertension grades(r=0.26),BMI(r=0.24),hs-CRP(r=0.40),circadian rhythm of blood pressure(r=0.30)and Gensini score(r=0.28)in patients with CHD,respectively(P<0.05).(3)AUC of Lp-PLA2 in diagnosing reverse-dipper blood pressure was 0.651 in patients with CHD,with optimum critical value of 301.5μg/L,that in diagnosing severe stenosis of coronary artery was 0.593,with optimum critical value of 225.0 μg/L.Conclusion Lp-PLA2 is significantly correlated positively with hypertension grades,BMI,hs-CRP,circadian rhythm of blood pressure and Gensini score in patients with CHD,respectively,which may reflect the change of
作者
刘向阳
唐良秋
范文茂
李爱华
庞军刚
冯应君
LIU Xiangyang;TANG Liangqiu;FAN Wenmao;LI Aihua;PANG Jungang;FENGYingjun(Department of Cardiovascular Medicine,Yue Bei People's Hospital Affiliated to Shantou University,Shaoguan 512026, China)
出处
《实用心脑肺血管病杂志》
2019年第7期88-92,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
广东省韶关市医药卫生科研计划项目(Y17015)
广东省韶关市科技局计划项目(2017CX/K011)
关键词
冠心病
脂蛋白相关磷脂酶A2
血压
昼夜节律
冠状动脉狭窄
诊断
Coronary disease
Lipoprotein-associated Phospholipases A2
Blood pressure
Circadian rhythm
Coronary stenosis
Diagnosis
