蛋白酪氨酸磷酸酶1B、血清淀粉样蛋白A、血浆脂蛋白磷脂酶A2三种炎性因子联合检测对2型糖尿病合并冠心病的早期风险判断中的作用分析

Analysis of the Role of Combined Detection of Three Inflammatory Factors PTP1B,A-SAA,and Lp-PLA2 in the Early Risk Judgment of T2DM Combined with Coronary Heart Disease

目的:探究联合检测蛋白酪氨酸磷酸酶1B(PTP1B)、血清淀粉样蛋白A(A-SAA)、血浆脂蛋白磷脂酶A2(Lp-PLA2)在诊断2型糖尿病(T2DM)合并冠心病中的价值。方法:选择2016年6月-2018年6月期间在雷州市人民医院检验科就诊的140例2型糖尿病患者为观察对象,依据是否伴有冠心病,分为单纯T2DM组和合并冠心病组。此外,选取50名健康者作为对照组,比较三组人群相关生理指标的差异。采用全自动生化仪测定总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等4项传统血脂指标。采用酶联免疫吸附法测血清PTP1B、血浆Lp-PLA2水平以及HDL中SAA水平,分析指标水平与T2DM和冠心病之间的关系。结果:合并冠心病组HDL-C(0.99±0.43 mmol/L)低于单纯T2DM组(1.51±0.37mmol/L)和对照组(1.49±0.42mmol/L),差异有统计学意义(P<0.05)。合并冠心病组患者的TC、LDL-C(5.68±0.35mmol/L、3.35±0.63mmol/L)水平高于单纯T2DM组TC、LDL-C(5.22±0.87mmol/L、3.19±0.32mmol/L),组间差异有统计学意义(P<0.05)。合并冠心病组Lp-PLA2水平(265.43±42.95ng/mL)高于单纯T2DM组(141.54±39.56ng/mL)和对照组(39.49±47.17ng/mL);合并冠心病组PTP1B水平(89.36±14.65ng/L)高于单纯T2DM组(71.49±9.12ng/L)和对照组(47.50±13.86ng/L);合并冠心病组A-SAA水平(25.64±6.98mg/L)高于单纯T2DM组(16.56±6.98mg/L)和对照组(4.75±1.33mg/L),上述指标组间差异均有统计学意义(P<0.05)。结论:PTP1B、A-SAA、Lp-PLA2可能在冠状动脉粥样硬化的发病机制中发挥重要作用,是T2DM合并冠心病发生和发展的敏感指标,可作为预测风险T2DM合并冠心病风险的早期检测指标。联合检测PTP1B、A-SAA、Lp-PLA2对T2DM合并冠心病的诊断鉴别以及治疗决策具有重要的指导意义。

Objective: To explore the combined testing of protein tyrosine phosphatase 1 B(PTP1 B), serum amyloid A(A-SAA),plasma lipoprotein phospholipase A2(Lp-PLA2), and diagnosis of type 2 diabetes(T2DM) combined with coronary heart disease.Methods: 140 patients with type 2 diabetes who were treated in the hospital from June 2016 to June 2018 were selected as obser-vation objects. They were divided into T2DM group and combined coronary heart disease group based on whether they had coro-nary heart disease or not. In addition, 50 healthy people were selected as the control group, and the differences in relevant physio-logical indicators of the three groups were compared. Fully automatic biochemical analyzer was used to measure four traditionalblood lipid indicators including TC, TG, LDL-C, and HDL-C. The levels of serum PTP1 B, plasma Lp-PLA2, and SAA in HDLwere measured by enzyme-linked immunosorbent assay, and the relationship between the levels of indicators and T2DM and coro-nary heart disease was analyzed. Results: HDL-C(0.99±0.43 mmol/L) in the combined coronary heart disease group was lowerthan that in the T2DM group(1.51±0.37 mmol/L) and the control group(1.49±0.42 mmol/L), and the difference was statistically sig-nificant(P<0.05). The levels of TC and LDL-C(5.68±0.35 mmol/L, 3.35±0.63 mmol/L) in the combined coronary heart diseasegroup were higher than those in the T2DM group(5.22±0.87 mmol/L, 3.19±0.32 mmol/L), the difference between the groups wasstatistically significant(P<0.05). The level of Lp-PLA2 in the combined coronary heart disease group(265.43±42.95 ng/m L) washigher than that in the T2DM group(141.54±39.56 ng/m L) and the control group(39.49±47.17 ng/m L). The level of PTP1 B in thecombined coronary heart disease group(89.36±14.65 ng/L) was higher than the T2DM group(71.49±9.12 ng/L) and the controlgroup(47.50±13.86 ng/L). The level of A-SAA in the combined coronary heart disease group(25.64±6.98 mg/L) was higher thanthat of the T2DM group(16.56±6.98 mg/L) and the control group(4.75±1.33 mg/L). The differences between the above-mentioned indicators were statistically significant(P<0.05). Conclusion: PTP1 B, A-SAA, and Lp-PLA2 may play an important role in thepathogenesis of coronary atherosclerosis. They are sensitive indicators of the occurrence and development of T2DM with coronaryheart disease, and can be used as early detection indicators to predict the risk of T2DM with coronary heart disease. The combinedtesting of PTP1 B, A-SAA and Lp-PLA2 has important guiding significance for the diagnosis and treatment of T2DM with coronaryheart disease.