急性心肌梗死后血清前白蛋白及脂蛋白相关磷脂酶A2的变化及其临床意义

Changes and significance of serum prealbumin and Lp-PLA2 in patients with acute myocardial infarction

目的探讨急性心肌梗死(AMI)患者血清前白蛋白(PA)及脂蛋白相关磷脂酶A2(Lp-PLA2)的变化及其临床意义。方法选取2018年3月至2019年3月期间在兴山县人民医院确诊的AMI患者70例作为AMI组,同期健康体检者70例作为对照组,检测两组受检者的血清PA、Lp-PLA2水平,并分析AMI患者血清PA、Lp-PLA2水平与患者冠脉病变支数及心肌梗死6个月后患者左心射血分数(LVEF)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)之间的关系。结果AMI组患者的血清PA为(2.92±0.73)mg/mL,明显低于对照组的(3.57±0.62)mg/mL,Lp-PLA2为(178.3±55.4)ng/mL,明显高于对照组的(100.1±48.2)ng/mL,差异均有统计学意义(P<0.05);AMI组患者中,单支冠脉病变者的血清Lp-PLA2为(126.1±42.8)ng/mL,明显低于双支病变者的(169.6±50.3)ng/mL及三支病变者的(188.9±59.4)ng/mL,而双支病变者的血清Lp-PLA2明显低于三支病变者,差异均有统计学意义(P<0.05);AMI组患者中,单支冠脉病变者的PA为(3.67±0.56)mg/mL,明显高于双支病变者的(3.15±0.54)mg/mL及三支病变者的(2.81±0.45)mg/mL,而双支病变者的血清PA明显高于三支病变者,差异均有统计学意义(P<0.05);AMI患者血清PA与LVEF呈正相关(r=0.674,P<0.01),与LVEDd(r=-0.553,P<0.01)及LVESd(r=-0.532,P<0.01)呈负相关;AMI患者的血清Lp-PLA2与LVEF呈负相关(r=-0.546,P<0.01),与LVEDd(r=0.575,P<0.01)及LVESd(r=0.591,P<0.01)呈正相关。结论测定AMI患者的血清PA、Lp-PLA2水平可以判断冠脉病变的严重程度,并且与患者心功能具有一定的相关性。

Objective To investigate the changes and significance of serum prealbumin(PA)and Lp-PLA2 in patients with acute myocardial infarction(AMI).Methods A total of 70 AMI patients diagnosed at Xingshan People’s Hospital from March 2018 to March 2019 were selected as the AMI group,and 70 healthy people during the same period were selected as the control group.The levels of serum PA and Lp-PLA2,and the correlations between serum PA,Lp-PLA2 levels,and left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDd),left ventricular end systole diameter(LVESd),number of coronary lesions in AMI patients were also analyzed.Results The serum PA level in AMI group was(2.92±0.73)mg/m L,which was significantly lower than(3.57±0.62)mg/m L in control group.The serum Lp-PLA2 level in AMI group was(178.3±55.4)ng/m L,which was significantly higher than(100.1±48.2)ng/m L in control group(P<0.05).The serum Lp-PLA2 level in single coronary artery disease was(126.1±42.8)ng/m L,which was significantly lower than(169.6±50.3)ng/mL in double coronary artery disease and(188.9±59.4)ng/mL in three coronary artery disease;the serum Lp-PLA2 level in double coronary artery disease was significantly lower than that in three coronary artery disease;the differences were both statistically significant(P<0.05).The serum PA level in single coronary artery disease was(3.67±0.56)mg/mL,which was significantly higher than(3.15±0.54)mg/mL in double coronary artery disease and(2.81±0.45)mg/mL in three coronary artery disease;while,the serum PA level in double coronary artery disease was significantly higher than that in there coronary artery disease;the differences were both statistically significant(P<0.05).The serum PA level was positively correlated with LVEF(r=0.674,P<0.01),but negatively correlated with LVEDd(r=-0.553,P<0.01)and LVESd(r=-0.532,P<0.01).The serum Lp-PLA2 level was negatively correlated with LVEF(r=-0.546,P<0.01),but positively correlated with LVEDd(r=0.575,P<0.01)and LVESd(r=0.591,P<0.01).Conclusion The determination of serum PA and Lp-PLA2 levels in patients with AMI can determine the severity of coronary artery disease and are related to the recovery of cardiac function.