脂蛋白相关磷脂酶A2监测在预防动脉粥样硬化性心血管疾病中的价值

Value of monitoring lipoprotein-associated phospholipase A2 in the prevention of atherosclerotic cardiovascular disease

目的评估血清脂蛋白相关磷脂酶A2(Lp-PLA2)活性对于体检人群的动脉粥样硬化性心血管疾病(ASCVD)10年发病风险的影响及监测价值。方法选取2018年9月至2020年8月临床确诊ASCVD患者83例,分为未服用调脂药物组36例和服用调脂药物组47例。另选取同期健康体检者161例作为正常对照组,按ASCVD的10年风险半定量评估方法将正常对照组再分为低危组75例,中危组50例,高危组36例。收集体检者性别、年龄、身高、体重、高血压史、糖尿病史、吸烟史等基本信息,通过实验室信息系统调取全部入组者的血脂指标等实验室检查结果。比较各组一般资料和血脂相关指标及Lp-PLA2活性水平的差异。结果各组血脂平均水平及Lp-PLA2比较,存在统计学差异。正常对照组的中、高危组及ASCVD未服用调脂药物组的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和Lp-PLA2活性明显高于低危组(P<0.05),ASCVD未服用调脂药物组明显高于ASCVD服用调脂药物组(P<0.05);中、高危组及ASCVD组的HDL-C明显低于低危组(P<0.05)。中危组与高危组Lp-PLA2活性比较,差异无统计学意义(P>0.05)。结论Lp-PLA2活性对ASCVD的10年发病风险具有重要影响,服用调脂药物可明显降低Lp-PLA2活性水平,体检人群中的中高危人群定期监测Lp-PLA2活性对ASCVD预防具有重要意义。

Objective To evaluate the effect and prediction of lipoprotein-associated phospholipase A2(Lp-PLA2)activity on the 10-year risk of atherosclerotic cardiovascular disease(ASCVD)in physical examination population.Methods A total of 83 clinically confirmed ASCVD patients from September 2018 to August 2020 were selected and divided into two groups:36 patients in the group without taking lipid-regulating drugs and 47 patients in the group taking lipid-regulating drugs.Another 161 healthy individuals during the same period were selected as the normal control group.According to the 10-year semi-quantitative risk assessment method of ASCVD,the normal control group was further divided into low-risk group(75 cases),medium-risk group(50 cases),and high-risk group(36 cases).Basic information such as gender,age,height,weight,history of hypertension,history of diabetes,and history of smoking were collected,and laboratory test results such as blood lipid indexes of all participants were obtained through the laboratory information system.The differences of general data,blood lipid related indexes and Lp-PLA2 activity level were compared among groups.Results There were significant differences in the average levels of blood lipid and Lp-PLA2 among the groups.The activities of TC,TG,LDL-C and Lp-PLA2 in medium and high risk groups and ASCVD group without lipid-lowering drugs were significantly higher than those in low-risk group(P<0.05),and ASCVD without lipid-lowering drugs was significantly higher than that in ASCVD with lipid-lowering drugs(P<0.05).The HDL-C of middle and high risk groups and ASCVD group was significantly lower than that of low risk group(P<0.05).There was no significant difference in Lp-PLA2 activity between the medium-risk group and the high-risk group(P>0.05).Conclusion Lp-PLA2 activity has an important effect on ASCVD 10-year risk.Lipid-regulating drugs can significantly reduce the activity level of Lp-PLA2,and regular monitoring of Lp-PLA2 activity in middle and high-risk population of physical examination is of great significance for ASCVD prevention.