质量法与酶活法检测血清脂蛋白相关磷脂酶A2在心脑血管疾病中的比较

Quality method versus enzyme activity method in detection of serum lipoprotein-associated phospholipase A2 in cardiovascular and cerebrovascular diseases

目的 探讨质量法检测血清脂蛋白相关磷脂酶A2 (Lp-PLA2)在急性心肌梗死和急性脑梗死中的诊断效能.方法 选取在心内科就诊的行血管造影并确诊的急性心肌梗死患者38例,急性脑梗死患者29例,体检健康者76例,收集血清以质量法和酶活法分别检测,分析两种方法的诊断效能.结果 急性心肌梗死组中,质量法检测结果为阳性36例、阴性2例,阳性率94.74%,酶活法检测结果为阳性35例、阴性3例,阳性率92.11%,2种检测方法诊断试验受试者工作特征曲线(ROC)曲线下面积分别为0.851、0.846.急性脑梗死组中,质量法检测结果为阳性24例、阴性5例,阳性率82.76%;酶活法检测结果为阳性2例、阴性27例,阳性率6.90%,2种检测方法诊断试验ROC曲线下面积分别为0.784、0.101.健康组76例均为阴性.2种方法检测急性心肌梗死无显著差异(P>0.05),检测急性脑梗死则差异显著(P<0.05).结论 质量法检测血清Lp-PLA2在急性心肌梗死和急性脑梗死的诊断中具有较高的特异度与准确率,可作为急性心肌梗死和急性脑梗死的诊断方法,弥补了心血管造影的局限性.

Objective To explore the clinical value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)detected by quality method in cardiovascular and cerebrovascular diseases.Methods A total of 38 patients confirmed as acute myocardial infarction undergoing angiography,29 cases with acute cerebral infarction,and 76 healthy cases with physical examinations were selected.Serum was collected and their Lp-PLA2 levels were detected by quality method and enzyme activity method to analyze their diagnostic efficacy.Results In the acute myocardial infarction group,36 cases were positive and 2 cases were negative by quality method,with a positive rate of 94.74%.A total of 35 cases were positive and 3 cases were negative by enzyme activity method,with a positive rate of 92.11%.The area under the ROC curve of the two detection methods was 0.851 and 0.846,respectively.In the acute cerebral infarction group,24 cases were positive and 5 cases were negative by quality method,with a positive rate of 82.76%.Two cases were positive and 27 cases were negative by enzyme activity method,with a positive rate of 6.90%.The area under the ROC curve of the two detection methods was 0.784 and 0.101,respectively.All the 76 cases in the healthy group were negative.There was no statistical difference between the two methods in the detection of acute myocardial infarction(P>0.05),but a significant difference was seen in the detection of acute cerebral infarction(P<0.05).Conclusion The detection of serum Lp-PLA2 by mass method has high specificity and accuracy in the diagnosis of acute myocardial infarction and acute cerebral infarction,which can be used as a diagnosis for acute myocardial infarction and acute cerebral infarction and makes up the limitations of angiography.