目的 探讨血清脂蛋白相关磷脂酶A2（LP-PLA2）的水平与动脉粥样硬化（AS）的相关性。方法 实验组选取临床诊断并经血管造影证实为AS的患者125例,同期选择55例健康体检者作为正常对照组。收集患者入院24h内的血清标本,统一检测LP-PLA2、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、超敏C反应蛋白（hs-CRP）水平。结果 LPPLA2在AS组明显高于健康对照组,差异有显著统计学意义（P〈0.001）;多因素Logistic回归分析提示血清Lp-PLA2水平是预测动脉粥样硬化疾病的独立危险因素（P〈0.05）;检测LP-PLA2对AS的敏感性和特异性分别为54.4%,92.73%,ROC曲线显示sd LDL-C的诊断效能AUC为0.747,高于hs-CRP;AS患者的血清LP-PLA2水平与血清hs-CRP水平、病变部位、病变程度以及AS患者的性别、年龄、吸烟、饮酒、高血压、高血糖无显著相关,与LDL-C、TC低度相关。结论 LP-PLA2在预测AS方面具有较高的敏感性和特异性,且不易受病变部位、病变程度以及其他高危因素和炎症因子的影响,可作为临床预测AS发生的危险因素。
Objective To investigate the relationship between the level of serum lipoprotein associated phospholipase A2 （ LP - PLA2） and atherosclerosis. Methods 125 AS patients with clinical diagnosis and confirmed by angiography were selected as experi- mental group, and 55 healthy subjects were chosen as the normal control group at the same time. Serum samples were collected within 24 hours after admission, and the level of LP - PLA2, low density lipoprotein cholesterol （ LDL - C） , total cholesterol （TC） and high sensitive C reactive protein（ hs - CRP） were unified detection. Results LP - PLA2 was significantly higher in the AS group than that in the healthy control group （ P 〈 0.001 ）. Multivariate logistic regression analysis showed that serum LP -PLA2 level was an inde- pendent risk factor for predicting atherosclerosis （ P 〈 0.05）. The sensitivity and specificity of detecting LP - PLA2, for the diagnosis of AS was 54.4% and 92.73%, respectively. The ROC curve showed that the diagnostic efficacy of LP - PLA2 was 0. 747, which was higher than hs - CRP. There was no significant correlation between the level of Lp - PLA2 in the patients with AS and serum hs - CRP level, lesion location, degree of lesion and sex, age, smoking, alcohol consumption, hypertension and hyperglycemia in the patients with AS . However, LP - PLA2 has a low correlation with LDL - C, TC. Conclusion LP - PLA2 has high sensitivity and specificity in predicting AS, and not easily affected by lesion location , degree of lesion and other high risk factors and inflammatory factor. It can be used as a clinical risk factor to predict the occurrence of AS.
Journal of Mudanjiang Medical College