脂蛋白相关磷脂酶A2预测老年急性冠状动脉综合征患者介入治疗后主要不良心血管事件

Efficacy of Lp-PLA2 in predicting incidence of MACE in elderly acute coronary syndrome patients after PCI

目的探讨血浆脂蛋白相关磷脂酶A2(Lp-PLA2)预测老年急性冠状动脉综合征(ACS)患者PCI术后主要不良心血管事件(MACE)的效能。方法选择2016年1月~2018年1月我院接诊的ACS患者146例,随访6个月,根据是否发生MACE,分为非MACE组95例和MACE组51例,比较2组相关指标差异,采用多因素logistic回归分析和ROC曲线分析。结果MACE组术后72 h血浆Lp-PLA2和高敏C反应蛋白水平明显高于非MACE组,差异有统计学意义[(174.82±12.46)mg/L vs(112.05±7.62)mg/L,(14.63±3.83)mg/L vs(6.41±2.39)mg/L,P<0.05];血浆Lp-PLA2、血清高敏C反应蛋白和LVEF是ACS患者PCI术后发生MACE的独立危险因素(P<0.05);血浆Lp-PLA2预测术后MACE的ROC曲线下面积高于高敏C反应蛋白和LVEF(0.895 vs 0.685和0.635,P<0.05)。结论ACS老年患者PCI术后血浆Lp-PLA2水平与近期预后有关,预测MACE的效能较好,临床应重视。

Objective To study the efficacy of Lp-PLA2 in predicting the incidence of major adverse cardiovascular events(MACE)in elderly acute coronary syndrome(ACS)patients after PCI.Methods One hundred and forty-six ACS patients admitted to our hospital from January 2016 to January 2018 and followed for 6 months were divided into MACE-free group(n=95)and MACE group(n=51).The parameters between the two groups were compared by multivariate logistic regression analysis and ROC curve analysis.Results The serum Lp-PLA2 level and high sensitive C-reaction protein(hs-CRP)level were significantly higher in MACE group than MACE-free group at 72 h after PCI(174.82±12.46 mg/L vs 112.05±7.62 mg/L,14.63±3.83 mg/L vs 6.41±2.39 mg/L,P<0.05).The serum Lp-PLA2 and hs-CRP levels and LVEF were independent risk factors for MACE in ACS patients after PCI(P<0.05).ROC curve analysis revealed that the area under ROC curve for serum Lp-PLA2 level was significantly larger than hs-CRP level and LVEF in predicting the incidence of MACE in ACS patients after PCI(0.895 vs 0.685 and 0.635,P<0.05).Conclusion The serum Lp-PLA2 level is related with the short-term outcome in ACS patients after PCI,with higher predicting efficacy for the incidence of MACE,and is worthy of attention in clinical practice.