血清Apelin-12、IMA、Lp-PLA2水平对心脏瓣膜手术患者预后的影响

Effects of serum Apelin-12, IMA and Lp-PLA2 levels on prognosis of patients with heart valve surgeries

目的:探讨血清脂肪细胞因子-12(Apelin-12)、缺血修饰蛋白(IMA)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平与心脏瓣膜手术患者预后的关系。方法:回顾性分析2019年1月至2020年3月于该院行心脏瓣膜手术的126例患者的临床资料。术后随访1年,统计心脏瓣膜手术患者预后情况,对可能影响预后的因素进行单因素分析,包括年龄、病程、术前心功能分级、原发疾病、瓣膜疾病类型、心脏指数(CI)及术前血清Apelin-12、IMA、Lp-PLA2水平等。采用受试者工作特征曲线分析术前血清Apelin-12、IMA、Lp-PLA2水平对预后的预测价值。结果:术后1年预后良好95例,预后不良31例;年龄、术前心功能分级、术前CI及术前血清Apelin-12、IMA、Lp-PLA2水平均与心脏瓣膜手术患者预后明显相关(P<0.05);ROC曲线分析结果显示,术前血清Apelin-12、IMA、Lp-PLA2水平对心脏瓣膜手术患者预后均有一定预测价值(曲线下面积为0.654、0.701、0.748,P<0.05)。结论:年龄、术前心功能分级、术前CI及术前血清Apelin-12、IMA、Lp-PLA2水平均与心脏瓣膜手术患者预后有关,其中Apelin-12是预后的保护因素,而IMA、Lp-PLA2是预后不良的危险因素。

Objective: To investigate correlations among serum adipocytokine-12(Apelin-12), ischemia modified protein(IMA), and lipoprotein associated phospholipase A2(Lp-PLA2) levels and prognosis of patients with cardiac valvular surgeries. Methods: The clinical data of 126 patients who underwent cardiac valvular surgeries in our hospital from January 2019 to March 2020 were retrospectively analyzed. They were followed up for 1 year after the surgery. The prognosis conditions of these patients were statistically analyzed. Univariate analysis was performed on the risk factors that might affect the prognosis, including patient age, disease course, preoperative cardiac function classification, primary disease,valve disease type, cardiac index(CI) and preoperative serum Apelin-12, IMA, Lp-PLA2 levels. Then, the predictive values of preoperative serum Apelin-12, IMA and Lp-PLA2 levels for the prognosis were analyzed by using the ROC curve. Results: 1 year after the surgery, the prognosis was good in 95 cases and poor in 31 cases. Age, preoperative cardiac function classification, preoperative CI, and preoperative serum Apelin-12,IMA, and Lp-PLA2 levels were significantly correlated with the prognosis of the patients with cardiac valvular surgeries(P<0.05). The ROC curve analysis showed that the preoperative serum Apelin-12, IMA, and Lp-PLA2 levels had certain predictive value for prognosis in the patients with cardiac valvular surgeries(AUC=0.654, 0.701, 0.748, P<0.05). Conclusions: Age, preoperative cardiac function classification, preoperative CI, and preoperative serum Apelin-12, IMA, and Lp-PLA2 levels are all related to the prognosis of the patients with cardiac valvular surgeries. Among them,PLA2 is a protective factor for prognosis;however, IMA and Lp-PLA2 are risk factors for poor prognosis.