sCD40L Lp-PLA2对行急诊PCI中发生心肌缺血/再灌注损伤评估价值

Evaluation Value of sCD40L and Lp-PLA2 in Myocardial Ischemia/reperfusion Injury During PCI

目的:探讨可溶性CD40配体(sCD40L)、脂蛋白相关磷脂酶A2(Lp-PLA2)对急性心肌梗死患者行急诊介入治疗后发生缺血再灌注损伤的预测价值。方法:连续选取首次诊断为急性心肌梗死并行急诊PCI治疗的患者100例,收集发生缺血再灌注损伤情况和临床资料以及实验室指标,采用酶联免疫吸附试验(ELISA)检测Lp-PLA2、sCD40L浓度,分析Lp-PLA2、sCD40L对心肌缺血再灌注损伤的预测价值。结果:心肌缺血/再灌注损伤组Lp-PLA2、sCD40L水平明显高于非心肌缺血/再灌注损伤组(P<0.05),不同浓度组分析,高浓度组发生缺血再灌注损伤比低浓度组多。多因素Logistic回归分析发现Lp-PLA2、sCD40L是心肌缺血再灌注损伤独立危险因素(OR:1.655,1.146,P<0.05),两者ROC曲线下面积分别为0.740、0.697,并且两者联合绘制ROC曲线下面积为0.811。结论:脂蛋白相关磷脂酶A2、可溶性CD40配体对行急诊PCI后发生心肌再灌注损伤的风险有很好的预测价值。

Objective:To explore the predictive value of soluble CD40 ligand(sCD40L)and lipoprotein associated phospholipase A2(Lp-PLA2)in acute myocardial infarction(AMI)patients after emergency intervention.Methods:100 patients with acute myocardial infarction and PCI were selected for the first time in a row.The ischemia-reperfusion injury,clinical data and laboratory indexes were collected.The concentrations of Lp-PLA2 and sCD40L were detected by enzyme-linked immunosorbent assay(ELISA).The predictive value of Lp-PLA2 and sCD40L on myocardial ischemia-reperfusion injury was analyzed.Results:The levels of Lp-PLA2 and sCD40L in the myocardial ischemia/reperfusion injury group were significantly higher than those in the non myocardial ischemia/reperfusion injury group(P<0.05).Multiple logistic regression analysis showed that Lp-PLA2 and sCD40L were independent risk factors of myocardial ischemia-reperfusion injury(or:1.655,1.146,P<0.05).The area under ROC curve of them was 0.740 and 0.697 respectively,and the area under ROC curve was 0.811.Conclusion:LPA 2 and soluble CD40 ligands have a good predictive value for the risk of myocardial reperfusion injury after PCI.