脂蛋白相关磷脂酶A2活性水平联合肌钙蛋白对急性心肌梗死的早期诊断价值

Lipoprotein-associated phospholipase A2 activity level combined with cardiactroponini in the early diagnosis of acute myocardial infarction

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)活性水平联合肌钙蛋白(cTn)对急性心肌梗死(AMI)的早期诊断价值。方法连续收集2019年1月至12月来我院胸痛中心做冠脉造影的患者182例。根据造影结果,患者分为AMI组和稳定/不稳定型心绞痛组(SA/UA)。结果与SA/UA组比较,AMI组患者血清Lp-PLA2活性水平更高[(175.41±58.05)u/L比(152.28±46.82)u/L,P<0.01]。Lp-PLA2与年龄和低密度脂蛋白(LDL)存在正相关。Lp-PLA2活性ROC曲线下面积(AUC)为0.612(95%CI:0.514~0.709,P=0.030),Lp-PLA2的cut-off值为156.5 u/L(敏感性61%,特异性62%)。Lp-PLA2水平与AMI的患病率相关,OR为1.008[95%CI:1.000~1.016,P=0.043]。结论Lp-PLA2活性水平不依赖于肾功能,联合cTn I,可作为胸痛患者AMI的早期生物学标志物之一。

Objective To explore the early diagnosis value of lipoprotein-related phospholipase A2 activity combined with troponin for acute myocardial infarction.Methods One hundred and eighty-two consecutive patients who had undergone coronary angiography in the Chest Pain Center of our hospital from January to December 2019 were recruited in this study.Patients were divided into AMI group and stable/unstable angina pectoris(SA/UA)group according to the results of coronary angiography.Results Lp-PLA2 activity was higher in AMI than SA/UA[(175.41±58.05)u/L vs.(152.28±46.82)u/L,P<0.01].Lp-PLA2 activity was positively related to age and LDL.The area under the ROC curve(AUC)of Lp-PLA2 activity used to predict AMI was 0.612(95%CI:0.514-0.709,P=0.030).The Lp-PLA2 cut-off value was 156.5 IU/L,and the sensitivity and specificity were 61%and 62%,respectively.Lp-PLA2 level was associated with the prevalence of AMI with an odds ratio(OR)of 1.008(95%CI:1.000-1.016,P=0.043).Conclusion Lp-PLA2 activity is independent of kidney function and may be complementary to cTnⅠas a risk biomarker of early AMI in patients with acute chest pain.