Lp(a)、OPN、NLR与冠心病患者并发狭窄性瓣膜病相关性

Correlation of Lp(a),OPN,NLR and coronary heart disease patients with stenotic valvular disease

目的探讨脂蛋白(a)[Lp(a)]、骨桥蛋白(OPN)、中性粒细胞与淋巴细胞比值(NLR)与冠心病患者并发狭窄性瓣膜病相关性。方法选取2018年1月至2021年1月本院收治的300例冠心病患者,根据是否并发狭窄性瓣膜病分为狭窄组(n=72)、无狭窄组(n=228),比较两组基线资料、Lp(a)、OPN、NLR水平,并比较狭窄组不同严重程度患者Lp(a)、OPN、NLR水平,采用多因素Logistic回归方程分析冠心病患者并发狭窄性瓣膜病的相关影响因素,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析各指标及联合预测冠心病患者并发狭窄性瓣膜病的价值。结果狭窄组心肌梗死史、冠脉病变支数、Gensini评分、Lp(a)、OPN、NLR与无狭窄组比较,差异有统计学意义(P<0.05);狭窄组不同严重程度患者Lp(a)、OPN、NLR:重度>中度>轻度,比较差异有统计学意义(P<0.05);将心肌梗死史、冠脉病变支数、Gensini评分控制后,Lp(a)、OPN、NLR仍与并发狭窄性瓣膜病相关(P<0.05);Lp(a)、OPN、NLR预测冠心病患者并发狭窄性瓣膜病的AUC为0.861、0.820、0.707,各指标联合预测冠心病患者并发狭窄性瓣膜病的AUC为0.915。结论 Lp(a)、OPN、NLR升高与冠心病患者并发狭窄性瓣膜病风险增加有关,联合检测三者对狭窄性瓣膜病具有较高的预测效能,能为临床防治不良心血管事件的发生提供参考。

Objective To investigate the correlation between lipoprotein(a) [Lp(a)],osteopontin(OPN),neutrophil to lymphocyte ratio(NLR) and coronary heart disease patients with stenotic valvular disease.Methods A total of 300 patients with coronary heart disease admitted to our hospital from January2018 to January 2021 were divided into stenosis group(n=72) and non-stenosis group(n=228) according to whether they were complicated by stenotic valvular disease,and the two groups were compared.Baseline data,Lp(a),OPN,NLR levels,and compare the Lp(a),OPN,NLR levels of patients with different severity in the stenosis group,and use the multivariate logistic regression equation to analyze the relevant influencing factors of coronary heart disease patients with stenotic valvular disease,Using receiver operating characteristic curve(ROC) and ROC area(AUC) to analyze the value of each index and jointly predict the value of coronary heart disease patients with stenotic valvular disease.Results The history of myocardial infarction,number of coronary artery lesions,Gensini score,Lp(a),OPN,NLR in the stenosis group compared with the non-stenosis group,the difference was statistically significant(P<0.05);Lp(a),OPN,NLR:severe>moderate>mild,the difference between pairwise comparisons was statistically significant(P<0.05);after the history of myocardial infarction,the number of coronary artery lesions,and the Gensini score were controlled,Lp(a),OPN,and NLR were still associated with concurrent stenosis Valvular disease related(P<0.05);Lp(a),OPN,NLR predict the AUC of patients with coronary heart disease complicated by stenotic valvular disease as0.861,0.820,0.707,and the combination of all indicators predicts the AUC of patients with coronary heart disease complicated by stenotic valv Is 0.915.Conclusion The increase of Lp(a),OPN and NLR is related to the increased risk of coronary heart disease complicated by stenotic valvular disease.The combined detection of the three has a high predictive power for stenotic valvular disease,and can prevent the occurrence of adverse cardiovascular events in the clinic.for reference.