PAPP-A、Lp-PLA2、FGF23在冠心病患者中的表达与诱发的危险因素分析

Expression of PAPP-A,Lp-PLA2 and FGF23 in coronary heart disease and their risk factors

目的 探讨妊娠相关血浆蛋白A (PAPP-A)、脂蛋白磷脂酶A2 (Lp-PLA2)、成纤维细胞生长因子-23 (FGF23)在冠状动脉粥样硬化性心脏病(冠心病)患者中表达与诱发的危险因素。方法选择2021年1月至2022年1月于青岛市市立医院就诊的96例冠心病患者作为病例组,另选择我院同期正常体检的健康人群95例作为对照组,分析血清PAPP-A、Lp-PLA2、FGF23水平变化情况与诱发疾病的危险因素。结果两组在年龄、性别、吸烟、饮酒、冠心病家族史比较,差异无统计学意义(P>0.05),病例组的糖尿病、高血压、总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)水平高于对照组,高密度脂蛋白胆固醇(HDL-C)水平低于对照组,差异有统计学意义(P<0.05);病例组患者血清PAPP-A、Lp-PLA2、FGF23水平显著高于对照组,差异有统计学意义(P<0.05);轻度组患者血清PAPP-A、Lp-PLA2、FGF23水平显著低于中度组和重度组。中度组患者血清PAPP-A、Lp-PLA2、FGF23水平低于重度组,差异有统计学意义(P<0.05)。以发生冠心病为因变量,进行多因素非条件Logistic分析,结果显示糖尿病、高血压、TC、TG、LDL-C、HDL-C、血清PAPP-A、Lp-PLA2及FGF23均是诱发冠心病的独立危险因素(P<0.05)。结论冠心病患者的PAPP-A、Lp-PLA2、FGF23表达异常,与病情程度关系密切,可作为评估疾病进展的指标,具有一定的临床意义。

Objective To study the expression of Pregnancy-associated plasma protein A(PAPP-A),lipoprotein Phospholipase A2(Lp-PLA2),fibroblast growth factor-23(FGF23)in coronary heart disease and their risk factors.Methods Ninety-six patients from 2021 to January 2022 and 95 healthy people during the same period were selected as the control group.The changes in serum PAPP-A,Lp-PLA2,and FGF23 levels and the disease risk factors were analyzed.Results There was no significant difference in age,sex,smoking,drinking,and family history of coronary heart disease between the two groups(P>0.05).The levels of diabetes,hypertension,total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)in the case group were higher than those in the control group,and the levels of high-density lipoprotein cholesterol(HDL-C)were lower than those in the control group.The difference was statistically significant(P<0.05).The serum levels of PAPP-A,Lp-PLA2,and FGF23 in the case group were significantly higher than those in the control group,with statistical significance(P<0.05);Serum levels of PAPP-A,Lp-PLA2,and FGF23 in the mild group were significantly lower than those in moderate group and severe group.The serum levels of PAPP-A,Lp-PLA2,and FGF23 in the moderate group were lower than those in the severe group,and the dfference was statistically significant(P<0.05).Multivariate Logistic analysis with the occurrence of coronary heart disease as the dependent variable showed that diabetes,hypertension,TC,TG,LDL-C,HDL-C,serum PAPP-A,Lp-PLA2,and FGF23 were all independent risk factors for coronary heart disease(P<0.05).Conclusion The abnormal expression of PAPP-A,Lp-PLA2,and FGF23 in patients with coronary heart disease is closely related to the severity of the disease.It can be used as an indicator to evaluate the disease progression,with high clinical aplication value.