冠心病患者血清Lp-PLA2、VEGF、S100-β水平与冠状动脉病变程度的关系研究

Relationship between serum Lp-PLA2,VEGF and S100-βlevels with coronary vessel lesion degree in patients with coronary heart disease

目的 探讨冠心病(CHD)患者血清脂蛋白相关磷脂酶(Lp-PLA2)、血管内皮生长因子(VEGF)、中枢神经特异性蛋白(S100-β)水平与冠状动脉病变程度的关系。方法 选取2022年3月至2023年2月该院收治的126例CHD患者作为CHD组,另选取同期该院102例体检健康者作为对照组。比较CHD组和对照组及CHD组冠状动脉病变不同程度患者Lp-PLA2、VEGF、S100-β水平差异。采用受试者工作特征(ROC)曲线分析Lp-PLA2、VEGF、S100-β水平对CHD的诊断效能。结果 CHD组血清Lp-PLA2、VEGF、S100-β水平高于对照组,差异有统计学意义(P<0.05),CHD组冠状动脉病变不同程度患者血清Lp-PLA2、VEGF、S100-β水平随着冠状动脉病变程度增加,水平升高(P<0.05)。ROC曲线分析结果显示,Lp-PLA2单项检测诊断CHD的灵敏度和特异度分别为78.8%、93.3%,曲线下面积(AUC)为0.913(95%CI:0.522~0.974),优于S100-β单项检测(Z=2.289,P<0.05),3项指标联合检测的灵敏度和特异度分别为74.1%、93.5%,AUC为0.921(95%CI:0.812~0.979),优于VEGF、S100-β单项检测,差异有统计学意义(Z=1.936、2.361,P<0.05)。结论 CHD患者血清Lp-pLA2、VEGF、S100-β水平高于健康人群,3项指标单项及联合检测在诊断CHD方面有一定的辅助参考价值。

Objective To investigate the relationship between serum lipoprotein-associated phospholipase A2(Lp-PLA2),vascular endothelial growth factor(VEGF)and central nervous specific protein(S100-β)levels with coronary vessel lesion degree in the patients with coronary heart disease(CHD).Methods A total of 126 cases of CHD admitted and treated in the this hospital from March 2022 to February 2023 were selected as the CHD group,and 102 healthy subjects underwent the physical examination in this hospital during the same period were selected as the control group.The differences in the Lp-PLA2,VEGF,S100-βlevels were compared between the CHD group and the control group and among the patients with different degrees of coronary vessel lesion in the CHD group.The receiver operating characteristic(ROC)curve was adopted to analyze the value of Lp-PLA2,VEGF and S100-βfor diagnosing CHD.Results The serum Lp-PLA2,VEGF and S100-βlevels in the CHD group were higher than those in the control group,and the difference was statistically significant(P<0.05);the serum Lp-PLA2,VEGF and S100-βlevels in the patients with different degrees of coronary vessel lesion in the CHD group were increased with the increase of coronary artery lesion degree(P<0.05).The ROC curve analysis results showed that the sensitivity and specificity of the Lp-PLA2 single detection for diagnosing CHD were 78.8%and 93.3%,respectively,and the area under the curve(AUC)was 0.913(95%CI:0.522-0.974),which was superior to the single detection of S100-β(Z=2.289,P<0.05).The sensitivity and specificity of the 3 indexes combined detection were 74.1%and 93.5%,respectively,AUC was 0.921(95%CI:0.812-0.979),which was better than the single detection of VEGF and S100-β,and the difference was statistically significant(Z=1.936,2.361,P<0.05).Conclusion The serum Lp-pLA2,VEGF and S100-βlevels in the patients with CHD are higher than those in the healthy people.The single and combined detection of these three indexes has a certain auxiliary reference value in diagnosing CHD.