Lp-PLA2、hs-CRP联合Gas6在诊断老年稳定型冠心病患者中的应用

Lp-PLA2,hs-CRP combined with Gas6 in the diagnosis of elderly patients with stable coronary artery disease

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、超敏C反应蛋白(hs-CRP)联合生长停滞特异性基因产物6(Gas6)在诊断老年稳定型冠心病患者中的应用效果,为患者病情诊断、监测提供参考。方法选取我院2020年8月~2022年8月收治的200例老年稳定型冠心病患者为观察组,同期200例健康体检者为对照组。比较两组一般临床资料、血管舒张功能(FMD)、Gensini评分情况;比较两组入院时血清Lp-PLA2、hs-CRP、Gas6水平,分析其与两组间差异指标的相关性,Logistic回归分析发生稳定型冠心病的危险因素,ROC分析3项血清指标水平联合检测对稳定型冠心病的诊断价值。结果观察组FDM低于对照组,Gensini评分高于对照组,差异有统计学意义(P<0.05);入院时观察组血清Lp-PLA2、hs-CRP、Gas6水平均高于对照组,差异有统计学意义(P<0.05);且与FMD均呈负相关(r=-0.745、-0.633、-0.681),与Gensini评分均呈正相关(r=6.158、5.367、7.024);Logistic回归分析显示,入院时Gensini评分>15.82分、血清Lp-PLA2>164.51ng/mL、hs-CRP>2.89mg/L、Gas6>249.30 pg/mL是发生稳定型冠心病的危险因素;入院时FMD>4.76%是发生稳定型冠心病的保护因素;血清Lp-PLA2、hs-CRP、Gas6水平联合诊断稳定型冠心病的AUC为0.883(95%CI:0.834~0.935)。结论血清Lp-PLA2、hs-CRP、Gas6与冠心病的发生、病情发展程度有关,其与Gensini评分、FMD均为发生稳定型冠心病的影响因素,三者联合检测诊断老年稳定型冠心病的价值较高。

Objective To investigate the effect of lipoprotein-associated phospholipase A2(Lp-PLA2)and ultrasensitive C-reactive protein(hs-CRP)combined with growth arrest-specific gene product 6(Gas6)in the diagnosis of elderly patients with stable coronary artery disease,and to provide reference for the diagnosis and monitoring of patients'conditions.Methods Two hundred elderly patients with stable coronary artery disease admitted to our hospital from August 2020 to August 2022 were used as the observation group,and 200 healthy physical examiners during the same period were used as the control group.We compared the general clinical data,vascular diastolic function(FMD)and Gensini score between the two groups,compared the serum Lp-PLA2,hs-CRP and Gas6 levels at the time of admission,analyzed their correlation with clinical differential indexes,analyzed the risk factors for the occurrence of stable coronary heart disease by logistic regression,and analyzed the value of the combined test of three serum index levels on stable coronary heart disease by ROC.Diagnostic value.Results FDM was lower in the observation group than in the control group,and Gensini score was higher than in the control group,the difference was statistically significant(P<0.05);serum Lp-PLA2,hs-CRP,and Gas6 levels were higher in the observation group than in the control group at admission,the difference was statistically significant(P<0.05);serum Lp-PLA2,hs-CRP,and Gas6 levels at admission were negatively correlated with FMD(r=-0.745,-0.633,-0.681)and positively correlated with Gensini score(r=6.158,5.367,7.024)(P<0.05).Logistic regression analysis showed that Gensini score(>15.82 points),serum Lp-PLA2(>164.51ng/mL),hs-CRP(>2.89 mg/L),and Gas6(>249.30pg/mL)levels at admission were risk factors for the development of stable coronary heart disease;FMD at admission(>4.76%)was protective factor for the occurrence of stable coronary artery disease;the AUC of serum Lp-PLA2,hs-CRP,and Gas6 levels combined to diagnose stable coronary artery disease was 0.883(95%CI:0.834 to 0.935).Conclusion Serum Lp-PLA2,hs-CRP and Gas6 are related to the occurrence and extent of coronary artery disease,and they are all influential factors for the occurrence of stable coronary artery disease together with Gensini score and FMD,and the combined test is of high value for the diagnosis of stable coronary artery disease in the elderly.