LP-PLA2、Lpa、Hcy联合检测在诊断冠心病中的价值分析

The Value of LP-PLA2,Lpa and Hcy in the Diagnosis of Coronary Heart Disease

目的:探讨脂蛋白相关磷脂酶A2(LP-PLA2)、脂蛋白a(Lpa)、血清同型半胱氨酸(Hcy)联合检测在诊断冠心病(CHD)中的临床价值。方法:选取笔者所在医院2017年1月-2018年12月收治的经冠状动脉造影明确诊断的冠心病患者90例(其中稳定型心绞痛21例,不稳定型心绞痛42例,急性心肌梗死27例),并选取同期健康体检者90例为对照组,所有患者均行LP-PLA2、Lpa、Hcy检测,评估上述指标联合检测对冠心病的诊断价值。结果:冠心病组LP-PLA2、Lpa、Hcy水平均高于对照组(P<0.05);急性心肌梗死组LP-PLA2、Lpa、Hcy水平均高于对照组、稳定型心绞痛组、不稳定型心绞痛组(P<0.05);冠心病组患者LP-PLA2、Lpa、Hcy检测阳性率高于对照组(P<0.05);LP-PLA2、Lpa、Hcy联合检测诊断冠心病的敏感度均高于单一检测(P<0.05),且特异度与单一检测比较差异无统计学意义(P>0.05)。结论:LP-PLA2、Lpa、Hcy水平在冠心病患者中明显升高,且随着病情的加重而升高,联合检测可提高对冠心病的诊断价值。

Objective:To investigate the clinical value of LP-PLA2,Lpa and Hcy in the diagnosis of coronary heart disease (CHD).Method:A total of 90 cases of coronary heart disease (21 cases of stable angina,42 cases of unstable angina,27 cases of acute myocardial infarction) diagnosed by coronary angiography were selected from our hospital from January 2017 to December 2018,and 90 cases of healthy people in the same period were selected as the control group.All patients were tested with LP-PLA2,Lpa,Hcy,and the diagnosis value of coronary heart disease by the combined detection of the above indicators was evaluated.Result:The levels of LP-PLA2,Lpa and Hcy in the coronary heart disease group were higher than those in the control group (P<0.05).The levels of LP-PLA2,Lpa and Hcy in the acute myocardial infarction group were higher than those in the control group,the stable angina pectoris group and the unstable angina pectoris group (P<0.05).The positive rates of LP-PLA2,Lpa and Hcy in the coronary heart disease group were higher than those in the control group (P<0.05).The sensitivity of combined detection of LP-PLA2,Lpa,and Hcy in the diagnosis of coronary heart disease were higher than that of the single test (P<0.05),and the specificity were not statistically different from that of the single test (P>0.05).Conclusion:The levels of LP-PLA2,Lpa and Hcy are significantly increased in patients with coronary heart disease,and increased with the aggravation of the disease.The combined detection of LP-PLA2,Lpa and Hcy can improve the diagnosis value of coronary heart disease.