糖尿病冠状动脉粥样硬化性心脏病患者测定血清脂蛋白相关磷脂酶A2和血脂水平的临床价值

Clinical Value of Determining Serum Lipoprotein-Associated Phospholipase A2 and Blood Lipid Levels in Patients with Diabetic Coronary Disease

目的：探讨糖尿病冠状动脉粥样硬化性心脏病（简称糖尿病冠心病）患者血清脂蛋白相关磷脂酶A2（Lp-PLA2）和血脂（TG、HDL-C、LDL-C、Lp（a）、ApoA1、ApoB和ApoB/ApoA1比值）水平的临床价值。方法采用酶联免疫分析、生化法和免疫比浊分析测定157例糖尿病冠心病患者血清Lp-PLA2和血脂水平，并与60名健康对照组进行比较性分析。受试者工作曲线（ROC曲线）分析血清Lp-PLA2、TG、HDL-C、LDL-C、Lp（a）、ApoA1、ApoB水平，并进行预测冠状动脉粥样硬化性心血管疾病（CVD）的性能评估。结果糖尿病冠心病患者血清Lp-PLA2、TG、LDL-C、Lp（a）、ApoB和ApoB/ApoA1比值水平明显增高，而血清HLD-C、ApoA1水平稍降低。ROC曲线分析表明：血清Lp-PLA2、LDL-C、ApoA1和ApoB水平具有预测冠状动脉硬化性CVD性能的价值，并以血清Lp-PLA2为最佳。结论糖尿病冠心病的特点是血糖和血脂代谢紊乱，胰岛素抵抗和高尿酸血症，血清Lp-PLA2、LDL-C、ApoA1、ApoB和ApoB/ApoA1比值测定具有早期诊断的临床价值，血清Lp-PLA2、LDL-C、ApoA1和ApoB水平是预测冠心病心血管事件的有价值指标。

Objective To explore the clinical value of determining serum lipoprotein-associated phospholipase A2 （Lp-PLA2） and blood lipid levels in patients with diabetic coronary disease.MethodsSerum Lp-PLA2 and blood lipid （TG, HLD-C, LDL-C, Lp（a）, ApoA1, ApoB and ApoB/ApoA1 ratio） were determined in 157 patients with diabetic coronary disease and 60 controls by enzyme-linked immunosorbent assay （ELISA）, biochemistry and immunoturbidimetry, and compared analysis was done. The receiver operating characteristic curve （ROC curve） was plotted to analyze serum Lp-PLA2, TG, HDL-C, LDL-C, Lp（a）, ApoA1 and ApoB levels as a prognostic clinical value indicator of coronary atherosclerosis cardiovascular disease （CVD）.ResultsThe serum Lp-PLA2, LDL-C, Lp（a）, ApoB and ApoB/ApoA1 ratio in patients with diabetic coronary disease were significantly higher than those in controls, but the serum HDL-C and ApoA1 levels were slightly decreased. ROC curve analysis showed that the serum Lp-PLA2, LDL-C, ApoA1 and ApoB levels were predicative index for coronary atherosclerosis CVD and the serum Lp-PLA2 level was excellent.Conclusion The typical features of diabetic coronary disease were glucose and blood lipid abnormal metabolism, insulin resistance and hyperuricemia. The determination of serum Lp-PLA2, LDL-C, ApoA1, ApoB and ApoB/ApoA1 ratio should be clinical value of early diagnosis. The serum Lp-PLA2, LDL-C, ApoA1 and ApoB levels were valuable predictor for coronary disease cardiovascular events.