缺血性修饰白蛋白、Lp-PLA2、hs-CRP和TC联合检测对冠心病早期诊断的意义

Significance of ischemic modified albumin,Lp-PLA2,high sensitivity C-reactive protein and total cholesterol in early diagnosis of coronary heart disease

目的:探讨缺血修饰白蛋白(IMA)、脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C-反应蛋白(hs-CRP)和血清总胆固醇(TC)的联合检测对冠心病患者早期诊断的意义。方法:选取2016年7月至2017年7月本院收治的120例冠心病患者,其中急性心肌梗死(AMI) 40例,稳定型心绞痛(SAP) 40例,不稳定型心绞痛(UAP) 40例。同时选取同期本院健康体检者40例为对照组。收集患者血液并检测血液中IMA、Lp-PLA2、hs-CRP和TC的含量。结果:与对照组相比,AMI组、SAP组和UAP组患者血清内Lp-PLA2、hs-CRP和TC含量显著升高,IMA含量显著降低,差异具有统计学意义(P <0. 05)。与SAP组相比,随着患者疾病程度的加重,AMI组和UAP组血清内Lp-PLA2、hs-CRP和TC含量显著升高,IMA含量显著降低,差异具有统计学意义(P <0. 05)。AMI组、SAP组和UAP组患者血清内IMA、Lp-PLA2、hs-CRP和TC单项检测的阳性率显著低于各指标的联合检出率,差异均有统计学意义(P <0. 05)。AMI组、SAP组和UAP组均与血清IMA蛋白存在显著的负性相关关系,Person相关系数为-0. 37,-0. 35,-0. 39,P <0. 01;与血清Lp-PLA2、hs-CRP和TC蛋白存在显著的正性相关关系,Person相关系数为正值,P <0. 01。结论:冠心病患者血清中Lp-PLA2、hs-CRP和TC含量显著升高,IMA含量显著降低; IMA、Lp-PLA2、hs-CRP和TC联合检测及实时监测对于诊断冠心病具有重要的临床意义。

Objective： To investigate the early diagnosis of coronary heart disease by the combined detection of ischemia-modified albumin（ IMA）,lipoprotein-related phospholipase A2（ Lp-PLA2）,high-sensitivity C-reactive protein（ hs-CRP）,and serum total cholesterol（ TC）. Methods： A total of 120 patients with coronary heart disease admitted to our hospital from July 2016 to July 2017 were selected. Forty patients with acute myocardial infarction（ AMI）,40 patients with stable angina pectoris（ SAP） and 40 patients with unstable angina pectoris 40 cases of unstable angina pectoris（ UAP） were selected. At the same time,40 healthy subjects in our hospital were selected into the control group. Blood was collected and the levels of IMA,Lp-PLA2,hs-CRP and TC in the blood were measured. Results： Compared with the control group,the levels of Lp-PLA2,hs-CRP and TC in patients with acute myocardial infarction（ AMI group）,stable angina pectoris（ SAP group） and unstable angina pectoris（ UAP group） were significantly lower,the difference was statistically significant（ P〈0. 05）. Compared with stable angina pectoris（ SAP group）,the levels of Lp-PLA2,hs-CRP and TC in AMI group and UAP group were increased significantly and the IMA content decreased significantly along with the severity of the disease,the difference was statistically significant（ P〈0. 05）. The positive rates of IMA,Lp-PLA2,hs-CRP and TC in serum of patients with acute myocardial infarction（ AMI group）,stable angina pectoris group（ SAP group） and unstable angina pectoris group（ UAP group）,the detection rate and the difference were statistically significant（ P〈0.05）.AMI group,SAP group and UAP group had significant negative correlation with serum IMA protein,Person correlation coefficient（-0. 37,-0. 35,-0. 39） was negative,（ P〈0. 01）; There was a significant positive correlation between serum Lp-PLA2,hs-CRP and TC protein. Person＇s correlation coefficient was positive（ P〈0.01）. Conclusion： The serum levels of Lp-PLA2,hs-CRP and TC in patients with coronary heart disease were significantly increased, and IMA levels were significantly decreased. The combined detection and real-time monitoring of IMA,Lp-PLA2,hs-CRP and TC have important clinical significance in the diagnosis of coronary heart disease.