Lp(a)、ApoB/ApoA1联合颈动脉Crouse积分对ACS的预测价值分析

Predictive Value Analysis of Lp(a), ApoB/ApoA1 Combined with Crouse Score for ACS

目的:探讨Lp(a)、ApoB/ApoA1水平及颈动脉超声Crouse积分对预测ACS的发生及冠脉病变程度的可行性。方法:随机选取2019年1月至2020年12月就诊于青岛大学附属医院心内科的ACS患者203例,并选取同期行冠状动脉造影提示无冠状动脉粥样硬化的患者118例作为对照组。比较两组患者基本临床资料、Lp(a)、ApoB/ApoA1水平、Crouse积分及其他实验室指标之间的差异。利用Spearman分析分析Lp(a)、ApoB/ApoA1水平、Crouse积分与冠脉Gensini积分之间的相关性。利用受试者工作曲线分析三者及三者联合检测对ACS的诊断价值。结果:ACS组Lp(a)、ApoB/ApoA1水平、Crouse积分均明显高于对照组,差异具有统计学意义(P 【0.01)。且三者同冠脉Gensini积分呈正相关,三者联合检测的AUC大于任一指标AUC。结论:Lp(a)、ApoB/ApoA1水平、Crouse积分可能是反映ACS的临床预测指标之一,且三者联合预测价值更高,且三者均能在一定程度上反应冠脉病变的严重程度。

Objective: To investigate the feasibility of Lp(a) and ApoB/ApoA1 levels in predicting the occurrence of ACS and the degree of coronary artery disease. Methods: A total of 203 ACS patients admitted to the Department of Cardiology, Affiliated Hospital of Qingdao University from January 2019 to December 2020 were randomly selected, and 118 patients without coronary atherosclerosis who underwent coronary angiography during the same period were selected as the control group. The differences of basic clinical data, Lp(a), ApoB/ApoA1 levels, Crouse score and other laboratory indicators were compared between 2 groups. Spearman analysis was used to analyze the correlation between Lp(a), ApoB/ApoA1 level, Crouse score and coronary Gensini score. The diagnostic value of the three tests and their combination for ACS was analyzed by using the subject operating curve. Results: Lp(a), ApoB/ApoA1 and Crouse score in ACS group were significantly higher than those in control group, the differences were statistically significant (P <0.01). In addition, the three were positively correlated with coronary Gensini score, and the AUC of the three combined detection was greater than that of any index. Conclusions: Lp(a), ApoB/ApoA1 level and Crouse score may be one of the clinical predictors of ACS, and their combined predictive value is higher, and all of them can reflect the severity of myocardial infarction to a certain extent.