血清Lp-PLA2、hs-CRP与骨钙素在冠心病中的诊断价值

The Diagnostic Value of Serum Lp-PLA2,hs-CRP and Osteocalcin in Coronary Heart Disease

目的探讨血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、骨钙素(osteocalcin,OS)在冠心病中的临床诊疗价值。方法选择2017年1月—2019年12月本院住院的冠心患者90例,分为稳定型心绞痛组(A组,30例)、不稳定型心绞痛组(B组,30例)和急性心肌梗死组(C组,30例)三个研究组,另选取30名健康体检者为对照组(D组,30例),分别测定其血清Lp-PLA2、hsCRP、OS的含量,用Spearman等级相关分析各指标与冠心病情的相关性,计算灵敏度、特异度等诊断效能指标。结果 (1)冠心病各组血清Lp-PLA2、hs-CRP含量均高于对照组(P <0.05),且各组间差异均有统计学意义(P <0.05),冠心病各组血清OS含量均低于对照组(P<0.05),且各组间差异均有统计学意义(P <0.05)。(2)血清LpPLA2、hs-CRP与冠心病病情呈正相关(rs=0.848、0.870,P <0.01);血清OS与冠心病病情呈负相关(rs=-0.762,P <0.01)。(3)血清Lp-PLA2、hs-CRP、OS的灵敏度分别为83.33%、85.56%、78.89%,特异度分别为93.33%、86.67%、93.33%,三者联合灵敏度为98.89%,特异度为73.33%,组间比较差异有统计学意义(P <0.05)。结论血清Lp-PLA2、hs-CRP、OS与冠心病病情密切相关,三者联合诊断可以提高诊断的灵敏度。

Objective To investigate the presence of serum lipoproteinassociated phospholipase A2(Lp-PLA2),hypersensitive C-reactive protein(hs-CRP),and osteocalcin(OS)in the clinical diagnosis and treatment of coronary heart disease.Methods A total of 90 patients with coronary heart disease who were hospitalized in our hospital from January 2017 to December 2019 were selected and divided into three study groups:stable angina group(group A,n=30),unstable angina group(group B,n=30)and acute myocardial infarction group(group C,n=30).Another 30 healthy subjects were selected as the control group(group D,n=30).The levels of serum Lp-PLA2,hs-CRP,OS were measured.Spearman rank correlation was used to analyze the correlation between each index and coronary heart disease,and the sensitivity and specificity were calculated.Results(1)The levels of serum Lp-PLA2 and hs-CRP in each group of coronary heart disease were higher than those of the control group(P<0.05),and the differences among the groups were statistically significant(P<0.05).Serum OS in each group of coronary heart disease the content were lower than that in the control group(P<0.05),and the differences among the groups were statistically significant(P<0.05).(2)Serum Lp-PLA2 and hs-CRP were positively correlated with coronary heart disease(rs=0.848,0.870,P<0.01);serum OS was negatively correlated with coronary heart disease(rs=-0.762,P<0.01).(3)The sensitivity of serum Lp-PLA2,hs-CRP,and OS were 83.33%,85.56%,78.89%,and the specificity of those were 93.33%,86.67%,93.33%,respectively.The sensitivity of combined detection of three indexes was 98.89%,and the specificity was 73.33%,and there was statistical difference among the groups(P<0.05).Conclusion Serum Lp-PLA2,hs-CRP,OS are closely related to coronary heart disease,and the combined diagnosis of the three can improve the sensitivity of diagnosis.