冠心病患者血清Lp-PLA2与HCY检测及其与冠状动脉病变程度的相关性分析

目的 探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)和同型半胱氨酸(HCY)水平检测与冠心病(CHP)患者冠状动脉病变程度的关系。方法 选取2017年1月～2018年5月延安大学附属医院经冠状动脉造影确诊的冠心病患者266例为实验组,其中男性161例,平均年龄57.3±8.5岁,女性105例,平均年龄61.1±11.6岁,选取同期该院冠状动脉造影阴性的体检者180例为对照组,其中男性97例,平均年龄54.6±10.5岁,女性83例,平均年龄47.5±6.3岁,记录两组性别、年龄、糖尿病史、卒中病史、心肌梗死病史、吸烟史和饮酒史,使用贝克曼AU2700全自动生化分析仪测定两组HCY,Lp-PLA2,空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和脂蛋白(a)Lp(a)]水平,分析两组各项指标的差异。秩和检验比较Gensini积分组 低积分组(Gensini积分<14分,n=128),中积分组(Gensini积分14～28分,n=83),高积分组(Gensini积分>28分,n=55)共3组] Lp(a),HCY水平之间的差异,秩和检验比较冠状动脉不同支数病变组 1支病变组(n=87)、2支病变组(n=91)、3支及3支以上病变组(n=88)共3组] Lp(a),HCY水平之间的差异。采用Pearson法分析Gensini积分与Lp-PLA2,HCY水平之间的相关性及Lp-PLA2与HCY水平之间的相关性。结果 实验组与对照组吸烟史、饮酒史及HCY,Lp-PLA2,Lp(a)水平为:59.77% vs 38.9%,86.84% vs 76.67%,53.7±21.8 μmol/L vs 6.5±4.1 μmol/L,366.1±114.3 μg/L vs 115.4±48.4 μg/L,569±283 mg/L vs 107±75.8 mg/L,差异均有统计学意义(t或χ²=7.78～18.75,均P<0.05)。Gensini低积分组、中积分组、高积分组HCY和Lp-PLA2水平为:39.6±20.2 μmol/L,50.7±26.4 μmol /L,68.5±31.8 μmol/L和245.4±88.3 μg/L,326.1±104.3 μg/L,459.4±113.5 μg/L,差异均有统计学意义(Z=5.81,15.25,均P<0.05)。冠状动脉1支病变组、2支病变组、3支及3支以上病变组HCY和Lp-PLA2水平为:48.6±27.2 μmol/L,47.8±23 μmol /L,74.1±38.6 μmol/L和201.4±73.5 μg/L,344.1±134.2 μg/L,530.6±255.3 μg/L,差异均有统计学意义(Z=5.63,17.91,均P<0.05),随Gensini积分的增加和冠状动脉病变支数的增多,HCY和Lp-PLA2水平升高,差异有统计学意义(t=5.43～16.57,均P<0.05),相关性分析显示Gensini积分与Lp-PLA2,HCY水平呈正相关(r=0.454,0.991,均P<0.05)。Lp-PLA2与HCY水平呈正相关(r=0.336,P<0.05)。结论 冠心病患者Lp-PLA2,HCY水平与冠状动脉病变程度呈正相关。

Detection of Serum Lp-PLA2 and HCY in Patients with Coronary Heart Disease and Its Correlation with the Degree of Coronary Artery Disease

Objective to explore the correlation between serum lipoprotein-related phospholipase A2(Lp-PLA2)and homocysteine(HCY)levels and the degree of coronary artery disease in patients with coronary heart disease.Methods Selection methods between January 2017 and May 2018,delay of establishing affiliated hospital after coronary angiography diagnosis of 266 patients with coronary heart disease(CHD)as the experimental group,161 cases of men,average age(57.3±8.5 years),105 cases of female,average age(61.1±11.6 years),select the same negative coronary angiography inour medical 180 cases as control group,97 cases of men,average age(54.6±10.5 years),83 cases of female,average age(47.5±6.3 years),History recordsof two groups of gender,age,diabetes mellitus,history of stroke,myocardialinfarction,history,history of smoking,drinking alcohol,using beckman AU2700automatic biochemical analyzer determination of two groups of HCY,Lp-PLA2,fasting blood glucose(FBG),three acyl glycerin(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein(a)Lp(a)]level,analysis the difference of each indexin both groups.Rank and inspection comparison Gensini score low score group(Gensini score <14 points,n=128),the integral group(Gensini score 14 ～28points,n=83),the high score group(Gensini score >28 points,n=55)atotal of three groups]Lp(a),the difference between HCY levels,rank and inspection comparison of coronary artery counts lesion group 1 lesion group(n=87),two lesion group(n=91),more than three and three lesion group(n=88),a total of 3] Lp(a),the difference between HCY levels.Pearson method was used to analyze the correlation between Gensini integral and Lp-PLA2 and HCYlevels and the correlation between Lp-PLA2 and HCY levels.ResultsThe smoking and drinking history of the experimental group and the control group as well as the levels of HCY,Lp-PLA2 and Lp(a)were:59.77% vs 38.9%,86.84% vs 76.67%,53.7±21.8 μmol/L vs 6.5±4.1 μmol/L,366.1±114.3 μg/L vs 115.4±48.4 μg/L and 569±283 mg/L vs 107±75.8 mg/L,thedifference was statistically significant(t or χ²=7.78～18.75, allP<0.05).The levels of HCY and Lp-PLA2 in the low-integral,medium-integral and high-integral groups of Gensini were:39.6±20.2 μmol/L,50.7±26.4 μmol /L,68.5±31.8 μmol /L and 245.4±88.3 μg/L,326.1±104.3 μg/L,459.4±113.5 μg/L with statistically significant differences(Z=5.81,15.25, all P<0.05).HCY and Lp-PLA2 levels were:48.6±27.2 μmol/L,47.8±23 μmol /L,74.1±38.6 μmol/L and 201.4±73.5 μg/L,344.1±134.2 μg/L,530.6±255.3 μg/L,with statistically significant differences(Z=5.63,17.91,all P<0.05).HCY and Lp-PLA2 levels increased with the increase of Gensini integral and coronary artery disease count(t=5.43～16.57,mean P<0.05).Correlation analysis showed that Gensini integral was positively correlated with Lp-PLA2 and HCY levels(r=0.454,0.991,mean P<0.05).Lp-PLA2 was positively correlated with HCY(r=0.336,P<0.05).Conclusion The levels of Lp-PLA2 and HCY in patients with coronary heart disease were positively correlated with the degree of coronaryartery disease.