Lp(a)、Hcy及sST2联合超声心动图对ACS诊断及预后的价值

Value of Lp(a),Hcy and sST2 combined with echocardiography in diagnosis and prognosis of ACS

目的探讨血浆脂蛋白a[Lp(a)]、血清同型半胱氨酸(Hcy)及可溶性生长刺激表达基因2蛋白(sST2)联合超声心动图对急性冠脉综合征(ACS)诊断及预后的价值。方法将2020年5月至2022年2月期间安徽省庐江县人民医院收治的96例ACS患者为观察组,根据预后情况分为预后良好组与预后不良组,根据认知障碍程度将患者分为轻度组、中度组、重度组,另选98名健康志愿者作为对照组,两组均进行Lp(a)、Hcy、sST2检测及超声心动图检查,采用多元Logistic回归分析Lp(a)、Hcy及sST2联合超声心动图检测与ACS患者预后的相关性。结果观察组左室射血分数(LVEF)低于对照组,左室舒张末内径(LVEDd)、Lp(a)、Hcy、sST2高于对照组,差异有统计学意义(t=17.122、86.717、4.622、20.868、19.076,P<0.05)。Lp(a)+Hcy+sST2+超声心动图检测诊断效能高于单项检测(P<0.05)。96例ACS患者轻度冠脉病变48例,中度冠脉病变28例,重度冠脉病变20例。随着冠脉病变程度加重,LVEDd、Lp(a)、Hcy、sST2升高,LVEF降低(F=9.429、11.103、6.365、10.627、9.955,P<0.05)。96例ACS患者中预后良好71例,预后不良25例。预后不良患者LVEDd、Lp(a)、Hcy、ST2指标均高于预后良好患者,LVEF低于预后良好者,差异有统计学意义(t=28.005,t=3.662,t=4.573,t=43.223,t=28.440,P<0.05)。LVEF、LVEDd、Lp(a)、Hcy、sST2指标均是ACS患者预后不良危险因素(P<0.05)。结论Lp(a)、Hcy及sST2联合超声心动图对ACS有较高的诊断价值,对ACS患者预后及病变程度均有一定评估价值。

Objective To investigate the value of plasma lipoprotein a[Lp(a)],serum homocysteine(Hcy)and soluble growth⁃stimulating gene 2(sST2)combined with echocardiography in diagnosis and prognosis of acute coronary syndrome(ACS).Methods 96 patients with ACS admitted to Lujiang County People's Hospital of Anhui Province from May 2020 to February 2022 were collected as the observation group,and were divided into the good prognosis group and the poor prognosis group according to the prognosis,and and patients were divided into mild prognosis group and mild prognosis group according to the degree of cognitive impairment.98 healthy volunteers were selected as the control group.Lp(a),Hcy and sST2 detection and echocardiography were performed in the both groups.Multiple logistic regression analysis was used to analyze the correlation between Lp(a),Hcy and sST2 combined with echocardiography and the prognosis of ACS patients.Results The left ventricular ejection fraction(LVEF)in the observation group was lower than that in the control group,and the left ventricular end⁃diastolic diameter(LVEDd),Lp(a),Hcy,and sST2 were higher than those in the control group,and the differences were statistically significant(t=17.122,86.717,4.622,20.868,19.076,P<0.05).Among the 96 ACS patients,48 had mild coronary artery disease,28 had moderate coronary artery disease,and 20 had severe coronary artery disease.With the aggravation of coronary lesions,the LVEDd,Lp(a),Hcy,and sST2(F=9.429,F=11.103,F=6.365,F=10.627)increased,while the LVEF(F=9.955)decreased(P<0.05).Among the 96 ACS patients,71 had good prognosis and 25 had poor prognosis.The LVEDd,Lp(a),Hcy and sST2 indicators in patients with poor prognosis were higher than those in patients with good prognosis,and the LVEF was lower than that of patients with good prognosis,the difference was statistically significant(t=28.005,t=3.662,t=4.573,t=43.223,t=28.440,P<0.05).LVEF,LVEDd,Lp(a),Hcy and sST2 were risk factors for poor prognosis in ACS patients(P<0.05).Conclusion Lp(a),Hcy and sST2 combined with echocardiography have a high diagnostic value for ACS,and have certain evaluation value for the prognosis and lesion degree of ACS patients.