血清Lp-PLA2、Hcy及hs-CRP与围绝经期冠心病患者冠状动脉病变严重程度的关系

Relationship between Lp-PLA2、Hcy、hs-CRP and the severity of coronary artery lesions in peri-menopausal patients with coronary heart disease

目的探讨围绝经期女性冠心病患者冠状动脉病变严重程度与血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、同型半胱氨酸(homocysteine,Hcy)及高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的关系。方法选择围绝经期女性冠心病患者112例,将冠状动脉造影结果进行Syntax评分,依据评分结果分为Ⅰ组(0～25分)、Ⅱ组(26～50分)、Ⅲ组(51～90分)和Ⅳ组(>90分)。检测4组血清Lp-PLA2、Hcy及hs-CRP值,并分析3个指标与冠状动脉病变严重程度的关系。结果Ⅱ组、Ⅲ组、Ⅳ组Lp-PLA2和Hcy高于Ⅰ组,Ⅳ组又高于Ⅱ组和Ⅲ组,差异均有统计学意义(P<0.05);Ⅱ组、Ⅳ组和Ⅳ组hs-CRP高于Ⅰ组,Ⅱ组和Ⅳ组又高于Ⅱ组,差异均有统计学意义(P<0.05)。Lp-PLA2、HCY、hs-CRP在冠状动脉病变中的ROC曲线下面积分别为0.821、0.933、0.551。结论血清Lp-PLA2、Hcy及hs-CRP联合可作为围绝经期女性冠心病严重程度的评估指标。

Objective To explore the relationship between the severity of coronary artery lesions and lipoprotein-associated phospholipase A2(Lp-PLA2),homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP)in peri-menopausal women with coronary heart disease.Methods A total of 112 peri-menopausal women with coronary heart disease were selected.According to the results of coronary angiography,they were divided intoⅠgroups(0 to 25 points),Ⅱgroups(26 to 50 points),Ⅲgroups(51 to 90 points)andⅣgroups( >90 points).Lp-PLA2,Hcy and hs-CRP values were detected in the four groups of patients,and the relationship between the three indicators and the severity of coronary lesions was analyzed.Results The Lp-PLA2 and Hcy ofⅡgroups,Ⅲgroups,Ⅳgroups were higher thanⅠgroups,andⅣgroups were higher thanⅡgroups,Ⅲgroups.The differences were statistically significant(P<0.05).The hs-CRP ofⅡgroups,Ⅲgroups,Ⅳgroups were higher thanⅠgroups,andⅢgroups,Ⅳgroups were higher thanⅡgroups.The differences were statistically significant(P<0.05).In the ROC curve analysis,the area under ROC curve of Lp-PLA2,Hcy and hs-CRP were 0.821,0.933 and 0.551 respectively.Conclusion Lp-PLA2 combined with Hcy and hs-CRP can be used to evaluate the severity of coronary heart disease in peri-menopausal women.