Lp-PLA2、PAR-2、AOPP联合检测对PCI术后支架内再狭窄的预测价值

Predictive values of combined detection of Lp-PLA2,PAR-2 and AOPP for instent restenosis after PCI

目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)、蛋白酶激活受体2(PAR-2)、晚期氧化蛋白产物(AOPP)联合检测与经皮冠状动脉介入术(PCI)术后支架内再狭窄的发生关系及其预测价值。方法选取PCI手术冠心病患者为研究对象,其中未发生支架内再狭窄为Ⅰ组,发生支架内再狭窄为Ⅱ组。用酶联免疫吸附法(ELISA)检测Lp-PLA2、PAR-2、AOPP表达,用受试者工作特征(ROC)分析及二元逻辑回归分析上述基因表达变化与支架内再狭窄发生风险的预测价值及独立危险因素。结果Ⅰ组纳入130例,Ⅱ组纳入58例。Ⅰ组患者与Ⅱ组患者在支架术后随访1年后的血液中Lp-PLA2的水平分别为(190.24±33.67)和(256.14±37.68)ng·mL^(-1),PAR-2水平分别为(1.41±0.38)和(1.95±0.43)ng·L^(-1),AOPP水平分别为(47.25±4.62)和(58.76±4.86)μmol·L^(-1),在统计学上差异均有统计学意义(均P<0.001)。ROC分析结果显示,Lp-PLA2、PAR-2、AOPP单独检测的截断值分别为201.32ng·mL^(-1)、1.50ng·mL^(-1)和49.37μmol·L^(-1),联合检测的曲线下面积(AUC)显著大于单独检测(均P<0.001)。二元逻辑回归分析表明,PCI术后发生支架内再狭窄的独立危险因素分别为Lp-PLA2≥201.32ng·mL^(-1)、PAR-2≥1.50ng·L^(-1)、AOPP≥49.37μmol·L^(-1)、LDL-C≥3.03mmol·L^(-1)(均P<0.05)。结论PCI术后支架内再狭窄的发生与Lp-PLA2、PAR-2、AOPP表达升高密切相关。

Objective To investigate the relationship between the combined detection of lipoprotein-associated phospholipase A2(LpPLA2),protease activated receptor 2(PAR-2),and advanced oxidation protein products(AOPP)and the occurrence of in-stent restenosis after percutaneous coronary intervention(PCI),as well as its predictive value.Methods Patients with coronary heart disease after PCI were selected as the study objects.GroupⅠwas the group without in-stent restenosis and groupⅡwas the group with in-stent restenosis.The expressions of Lp-PLA2,PAR-2 and AOPP were detected by enzyme-linked immunosorbent assay(ELISA),and the predictive value and independent risk factors of these gene expression changes and the risk of in-stent restenosis were analyzed by receiver operating characteristic(ROC)analysis and binary logistic regression analysis.Results The blood Lp-PLA2 levels in groupⅠand groupⅡafter 1 year follow-up after stenting were(190.24±33.67)and(256.14±37.68)ng·mL^(-1);PAR-2 levels were(1.41±0.38)and(1.95±0.43)ng·L^(-1),respectively;the AOPP levels were(47.25±4.62)and(58.76±4.86)μmol·L^(-1),respectively,and the differences were statistically significant(all P<0.001).ROC analysis results showed that the truncation values of Lp-PLA2,PAR-2 and AOPP were 201.32 ng·mL^(-1),1.50 ng·mL^(-1)and 49.37μmol·L^(-1),respectively.The area under the curve(AUC)was significantly higher than that detected alone(all P<0.001).Binary logistic regression analysis shows that the independent risk factors for in-stent restenstenosis after PCI were Lp-PLA2≥201.32 ng·mL^(-1),PAR-2≥1.50 ng·L^(-1),AOPP≥49.37μmol·L-1and LDL-C≥3.03 mmol·L^(-1),respectively(all P<0.05).Conclusion The occurrence of in-stent restenosis after PCI is closely related to the increase in Lp-PLA2,PAR-2 and AOPP expression.