外周血Lp-PLA2、LP(a)及hs-CRP与老年冠心病及其严重程度的关联性研究

Correlation among lipoprotein associated phospholipase A2,lipoprotein(a),high sensitivity C-reactive protein,coronary heart disease and disease severity in elderly patients

目的探究外周血脂蛋白相关磷脂酶A2(Lp-PLA2)、脂蛋白a[LP(a)]及超敏C反应蛋白(hs-CRP)与老年冠状动脉粥样硬化性心脏病(冠心病,CHD)及其严重程度的关联性。方法选取郑州中心医院于2020年5月至2023年5月期间收治的150例CHD患者,纳入CHD组,其中急性心肌梗死(AMI)54例、不稳定型心绞痛(UAP)57例、稳定型心绞痛(SAP)39例,分别纳入AMI组、UAP组、SAP组,另选取同时期健康体检者50例作为对照组。比较CHD组、对照组及CHD不同亚组外周血Lp-PLA2、LP(a)及hs-CRP水平。分析Lp-PLA2、LP(a)、hs-CRP与SYNTAX积分及指标之间的相关性。采用多元线性回归模型分析Lp-PLA2、LP(a)、hs-CRP对SYNTAX积分变化的影响。结果CHD组外周血Lp-PLA2、LP(a)、hs-CRP水平均高于对照组(P<0.05)。CHD不同亚组中,AMI组Lp-PLA2、LP(a)、hs-CRP及SYNTAX积分均高于UAP组和SAP组(P<0.05),且UAP组均高于SAP组(P<0.05)。Pearson相关性分析显示,Lp-PLA2、LP(a)、hs-CRP水平均与SYNTAX积分呈正相关(r=0.650、r=0.584、r=0.622,P均<0.01),Lp-PLA2与LP(a)、hs-CRP均呈正相关(r=0.452、r=0.683,P均<0.01),LP(a)与hs-CRP呈正相关(r=0251、r=0.680,P<0.05)。多元线性回归分析显示,Lp-PLA2、LP(a)、hs-CRP均对SYNTAX积分变化有独立影响(β=0.354、β=0.282、β=0.250,P<0.01)。结论老年冠心病患者外周血Lp-PLA2、LP(a)、hs-CRP水平高于健康人群,且随病情严重程度增加而升高。

Objective To investigate the correlation among peripheral blood lipoprotein associated phospholipase A2(Lp-PLA2),lipoprotein(a)[LP(a)],high sensitivity C-reactive protein(hs-CRP),coronary heart disease(CHD)and disease severity in elderly patients.Methods CHD patients(n=150)were chosen into CHD group from Zhengzhou Central Hospital from May 2020 to May 2023.In CHD group,there were 54 patients with acute myocardial infarction(AMI subgroup),57 with unstable angina(UAP subgroup)and 39 with stable angina(SAP subgroup).The healthy subjects with physical examination(n=50)were chosen into control group during the same period.The levels of Lp-PLA2,LP(a)and hs-CRP were compared among CHD group,control group and all subgroups.The correlation among Lp-PLA2,LP(a),hs-CRP and integrals and indexes of SYNTAX were analyzed.The influence of Lp-PLA2,LP(a)and hs-CRP on SYNTAX integral changes was analyzed by using multivariate linear regression model.Results The levels of peripheral blood Lp-PLA2,LP(a)and hs-CRP were higher in CHD group than those in control group(P<0.05).The levels of Lp-PLA2,LP(a)and hs-CRP and SYNTAX integrals were higher in AMI subgroup than those in UAP sub group and SAP subgroup(P<0.05),and were higher in UAP subgroup than those in SAP subgroup(P<0.05).The results of Pearson correlation analysis showed that levels of Lp-PLA2,LP(a)and hs-CRP were positively correlated to SYNTAX integrals(r=0.650,r=0.584,r=0.622,all P<0.01).The level of Lp-PLA2 was positively correlated to levels of LP(a)and hs-CRP(r=0.452,r=0.683,all P<0.01).The level of LP(a)was positively correlated to level of hs-CRP(r=0251,r=0.680,P<0.05).The results of multivariate linear regression analysis showed that levels of Lp-PLA2,LP(a)and hs-CRP had independent influence on SYNTAX integral changes(β=0.354,β=0.282,β=0.250,all P<0.01).Conclusion The levels of peripheral blood Lp-PLA2,LP(a)and hs-CRP are higher in elderly CHD patients than those in healthy population,and they will rise with the increase of disease severity.