血浆脂蛋白相关磷脂酶A2在冠状动脉病变患者中的临床应用价值

Clinical application value of plasma lipoprotein associated phospholipase A2 in patients with coronary arterial lesions

目的探讨血浆脂蛋白相关磷脂酶A2(lipoprotein associated phospholipaseA2,Lp-PLA2)在冠状动脉病变患者中的临床应用价值。方法2015年8月至2016年4月期间,选取四川成都市第五人民医院进行冠状动脉造影的患者187例进行研究,分析其基本情况、冠状动脉病变支数、Gensini积分、临床类型等分别对Lp-PLA2浓度及冠状动脉血流参数[左前降支收缩期峰流速(systolicpeakvelocity,SPV)、舒张期峰流速(diastolic peak velocity,DPV)、冠状动脉窦舒张期逆行心房波最大流速(A)、冠状动脉血流储备(coronary flow velocity reserve,CFVR)、舒张期时间速度积分(diastolic time velocity integral,CTVI)]的影响,分析Lp-PLA2浓度与冠状动脉血流参数的相关性,综合分析各因素对Lp-PLA2浓度的影响。结果急性冠状动脉综合征患者慢性疾病史、冠状动脉病变支数、Gensini积分、临床分型对Lp-PLA2浓度和冠状动脉血流参数(SPV、A、CFVR)影响显著(P<0.05);Lp-PLA2浓度与冠状动脉血流参数SPV、DPV、A、CFVR、CTVI分别呈正相关关系(r=18.635、14.633、17.308、19.647、15.887,P=0.000);以Lp-PLA2浓度为因变量,各影响因素进行拟合,有4个因素(慢性疾病史、病变支数、Gensini积分、临床分型)进入回归方程。结论血浆Lp-PLA2浓度对于早期诊断急性冠状动脉综合征有一定临床价值,其可以在一定程度上反映患者的冠状动脉粥样硬化程度等基本病情。

Objectives To explore the clinical value of plasma lipoprotein associated phospholipase A2(Lp-PLA2)in patients with coronary artery disease.Methods During August 2015 to April 2016,187 patients performed coronary angiography were selected in The Fifth People′s Hospital of Chengdu as research objects.Effects of basic situation, coronary artery lesion counts,Gensini score,clinical types on concentration of Lp-PLA2 and coronary blood flow parameters[systolic peak velocity(SPV),diastolic peak velocity(DPV),maximum velocity of retrograde atrial wave in diastolic phase of coronary sinus(A),coronary flow velocity reserve(CFVR),diastolic time velocity integral(CTVI)].Correlations of coronary blood flow parameters and concentration of Lp-PLA2 was analyzed.Effects of various factors on concentration of Lp-PLA2 were also analyzed.Results In patients with acute coronary syndrome,history of chronic disease,number of coronary artery lesion,Gensini score and clinical classification significantly affected concentration of Lp-PLA2 and coronary blood flow parameters(SPV,A,CFVR)(P<0.05).Coronary blood flow parameters(SPV,DPV,A,CFVR,CTVI)positively corrected with concentration of Lp-PLA2(r=18.635,14.633,17.308, 19.647,15.887;P=0.000).There were 4 factors(chronic disease history,lesion count,Gensini score and clinical classification)entering the regression equation with concentration of Lp-PLA2 as the dependent variable and the influencing factors fitted.Conclusions Concentration of Lp-PLA2 has certain clinical value for early diagnosis of acute coronary syndrome,which can reflect the degree of atherosclerosis to a certain extent.