冠心病患者血清磷脂转运蛋白活性与冠状动脉病变严重程度的相关分析

Correlation between serum phospholipid transfer protein activity levels and severity of coronary artery lesions in patients with coronary heart disease

目的 分析冠心病患者血清磷脂转运蛋白活性水平与冠状动脉病变严重程度的相关性。方法 2015年6月至2016年6月期间,无锡市锡山人民医院心血管科顺序入选胸痛患者202例,行冠状动脉造影术后分为冠心病组(n=121)和非冠心病组(n=81),计算Gensini评分,测定血清磷脂转运蛋白活性水平并行常规实验室检查。结果 冠心病组磷脂转运蛋白活性水平和Gensini评分显著高于非冠心病组[90.3(67~118)mg/dL比77.4(54.6~103.3)mg/dL,P<0.05;29(8~48)比2(0~6),P<0.001]。70~79岁与69岁及以下、男性与女性、糖尿病与非糖尿病患者相比,磷脂转运蛋白活性水平和Gensini评分明显升高(P<0.05)。多重线性回归分析提示冠心病组患者磷脂转运蛋白与Gensini评分相关(Beta=0.356,P<0.001)。ROC曲线分析显示磷脂转运蛋白曲线下面积为0.749(P<0.001)。结论 冠心病组磷脂转运蛋白活性水平与冠状动脉病变严重程度相关,磷脂转运蛋白活性水平可预测冠状动脉病变严重程度。

Aim To investigate the relationship between serum phospholipid transfer protein( PLTP) activity levels and severity of coronary artery lesions in patients with coronary heart disease( CHD). Methods 202 patients with chest pain were recruited in the Xishan People’s Hospital of Wuxi from June 2015 to June 2016,and these patients were divided into two groups based on coronary angiography( CHD group and non-CHD group). PLTP activity was measured with an assay kit,and the severity of coronary artery disease assessed by Gensini score was analyzed. Results PLTP activity levels and Gensini score in CHD group were significantly higher than that in non-CHD group( 90. 3( 67 ~118) mg/dL vs 77.4( 54.6 ~ 103. 3) mg/dL,P < 0. 05; 29( 8 ~ 48) vs 2( 0 ~ 6),P < 0. 001). PLTP activity levels and Gensini score were higher in patients aged 70 ~ 79 years old,male and diabetes than patients aged 60 ~ 69 years old,female and non-diabetes. Multiple linear regression analysis showed that PLTP activity levels were predictor for Gensini score after adjusting for the other risk factors( Beta = 0.356,P<0.001). ROC curve was for PLTP activity levels to detect CHD patients with upper Gensini score quartile,and the area under the curve was 0.749( P< 0.001). Conclusion Serum PLTP activity levels were predictive for the severity of coronary artery lesions in patients with CHD.