脂蛋白相关磷脂酶A2和高敏C反应蛋白联合检测对冠状动脉粥样硬化性心脏病的诊断价值

Diagnostic value of lipoprotein associated phospholipase A2 combined with high-sensitivity C-reactive protein in coronary atherosclerotic heart disease

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)和高敏C反应蛋白(hs-CRP)联合检测对冠状动脉粥样硬化性心脏病(简称“冠心病”)的诊断价值。方法选择2022年4月至2023年4月就诊于东莞市中西医结合医院的52例冠心病患者设为病例组(病变程度:轻度16例,中度20例,重度16例),52例健康体检者设为参考组。采集所有受检者3 ml外周血液,检测hs-CRP、Lp-PLA2。比较两组hs-CRP、Lp-PLA2检测值差异,并分析hs-CRP、Lp-PLA2单一与联合检测诊断冠心病的价值。结果病例组的hs-CRP、Lp-PLA2检测值高于参考组,差异有统计学意义(P<0.05);重度组患者的hs-CRP、Lp-PLA2检测值高于中度组和轻度组,且中度组的hs-CRP、Lp-PLA2检测值高于轻度组,差异有统计学意义(P<0.05)。hs-CRP、Lp-PLA2联合检测诊断冠心病的曲线下面积(AUC)为0.880(95%CI:0.815~0.944),灵敏度为0.904,特异度为0.732,约登指数为0.636,均高于单一检测。结论hs-CRP、Lp-PLA2均是诊断冠心病的有效指标,两者联合检测可提高诊断准确性,为临床治疗提供参考依据。

Objective To explore the diagnostic value of lipoprotein associated phospholipase A2(Lp-PLA2)and high-sensitivity C-reactive protein(hs CRP)in coronary atherosclerotic heart disease(CHD).Methods A total of 52 patients with CHD who were admitted to Dongguan Integrated Traditional Chinese and Western Medicine Hospital from April 2022 to April 2023 were selected as the case group(degree of disease:16 cases of mild disease,20 cases of moderate disease,16 cases of severe disease),and 52 healthy physical examination subjects were selected as the reference group.3 ml of peripheral blood was collected from all subjects,and hs-CRP and Lp-PLA2 were detected.The difference of hs-CRP and Lp-PLA2 detection values between the two groups was compared,and the value of single and combined hs-CRP and Lp-PLA2 detection in the diagnosis of coronary heart disease was analyzed.Results The hs-CRP and Lp-PLA2 values of the case group were higher than those of the reference group,and the differences were statistically significant(P<0.05).The detection values of hs-CRP and Lp-PLA2 in severe group were higher than those in moderate and mild groups,and the detection values of hs-CRP and Lp-PLA2 in moderate group were higher than those in mild group,the differences were statistically significant(P<0.05).The area under the curve(AUC)of hs-CRP and Lp-PLA2 combined detection in the diagnosis of CHD was 0.880(95%CI:0.815-0.944),the sensitivity was 0.904,the specificity was 0.732,and the Yoden index was 0.636,all of which were higher than that of single detection.Conclusion hs-CRP and Lp-PLA2 are both effective indicators for the diagnosis of coronary heart disease,and their combined detection can improve diagnostic accuracy and provide a reference basis for clinical treatment.