Lp-PLA2、D-二聚体及Galectin-3与冠心病患者冠状动脉粥样硬化易损斑块的关系研究

Study on the relationship between Lp-PLA2, D-dimer, Galectin-3 and atherosclerotic vulnerable plaque in patients with coronary heart disease

目的:探究血清磷脂酶A2(Lp-PLA2)、D-二聚体、血清半乳糖凝集素3(Galectin-3)与冠心病患者冠状动脉粥样硬化易损斑块的关系和临床价值。方法:选取在本院进行冠状动脉造影(CAG)和血管内超声检查(IVUS)的患者248例,并根据检查结果将其分为易损斑块组(89例)、稳定斑块组(89例)和对照组(70例)。比较各组血清Lp-PLA2、D-二聚体及Galectin-3水平及与检测参数的相关性;评估Lp-PLA2、D-二聚体及Galectin-3对冠心病患者冠状动脉粥样硬化易损斑块的临床价值。结果:各组血清Lp-PLA2、D-二聚体、Galectin-3水平差异明显(P<0.05),且对照组<稳定斑块组<易损斑块组(P<0.05)。相关分析显示,Lp-PLA2、D-二聚体、Galectin-3与斑块面积、斑块负荷、坏死核心、钙化组织均呈显著正相关(P<0.01),与纤维脂质、纤维组织呈明显负相关(P<0.01)。ROC曲线显示,Lp-PLA2、D-二聚体、Galectin-3对冠状动脉粥样硬化易损斑块具有一定预测价值(AUC=0.939、0.977、0.920,P<0.01),且3项联合(AUC=0.986,P<0.01)预测价值较高。结论:血清Lp-PLA2、D-二聚体及Galectin-3与冠心病患者冠状动脉粥样硬化易损斑块相关性明显,且敏感度、特异度均较高,可用于在早期冠状动脉粥样硬化易损斑块的诊断和治疗。

Objective:To explore the relationship of serum phospholipase A2(Lp-PLA2),d-dimers,and serum galectin-3(galectin-3)with atherosclerotic vulnerable plaques in coronary artery patients with coronary heart disease,and their clinical value.Methods:A total of 248 patients who underwent coronary angiography(CAG)and intravascular ultrasound(IVUS)in our hospital from June 2017 to September 2018 were selected and divided into the vulnerable plaque group(89),the stable plaque group(89)and the control group(70)according to the examination results.The serum levels of Lp-PLA2,d-dimer and galectin-3 in three groups were compared,and the correlation of the parameters was detected.To evaluate the clinical value of Lp-PLA2,d-dimer and galectin-3 in patients with coronary artery disease(CHD)with atherosclerotic vulnerable plaque.Results:Serum Lp-PLA2,d-dimer and galectin-3 levels were significantly different in the three groups(P<0.05),and the control group<the stable plaque group<the vulnerable plaque group(P<0.05).Correlation analysis showed that Lp-PLA2,d-dimer and galectin-3 were significantly positively correlated with plaque area,plaque load,necrotic core and calcified tissue(P<0.01),and negatively correlated with fibrous lipid and fibrous tissue(P<0.01).ROC curve showed that Lp-PLA2,d-dimer and galectin-3 had certain predictive value for vulnerable coronary atherosclerotic plaques(AUC=0.939,0.977,0.920,P<0.01),and the three combinations(AUC=0.986,P<0.01)had higher predictive value.Conclusion:Serum Lp-PLA2,d-dimer and galectin-3 are significantly correlated with coronary atherosclerotic vulnerable plaques in patients with coronary heart disease,with high sensitivity and specificity,which can be used for the diagnosis and treatment of early atherosclerotic vulnerable plaques.