急性冠脉综合征患者血清Lp-PLA2、CXCL16及NLR等指标与冠脉病变严重程度的相关性研究
发布时间:2018-12-26 06:56
【摘要】:目的:旨在分析脂蛋白相关磷脂酶A2(Lp-PLA2)、趋化因子配体16(CXCL16)、中性粒细胞计数及中性粒细胞数与淋巴细胞数比值(NLR)与急性冠脉综合征患者冠脉病变严重程度、易损斑块的相关性。方法:1)研究对象及分组:选取2016年1月-2017年2月在遵义医学院附属医院心内科住院行CAG检查诊断为冠心病患者224例,分为急性冠脉综合征(ACS)组和稳定型心绞痛(SAP)组,其中ACS组186例(UA 75例、NSTEMI 52例、STEMI 59例),SAP组38例。将ACS组中行OCT检查患者据OCT结果分为易损斑块(VP)组和稳定型斑块(SP)组,其中VP组9例,SP组8例;ACS组据Gensini评分结果分为低水平组57例,中等水平组70例,高水平组59例。2)检测血清中Lp-PLA2、CXCL16水平,所有患者均在CAG检查前经介入途径采集动脉血。将处理好的血清贮藏于-80℃低温冰箱保存,统一采用酶连免疫吸附测定法(ELISA)测定其浓度。由遵义医学院检验科协助分析血清中性粒细胞计数、NLR水平。结果:1)通过比较SAP组、UA组、NSTEMI组及STEMI组间一般资料及血生化指标发现:高血压、糖尿病、吸烟在四组间存在统计学差异(P㩳0.05),TC、LDL、Lp-PLA2、CXCL16、中性粒细胞计数及NLR水平在SAP组、UA组、NSTEMI组及STEMI组中依次呈递增趋势,且差异有统计学意义(P㩳0.05),而在年龄、性别、饮酒方面,四组间比较差异无统计学意义(P㧐0.05)。2)与SAP组相比,ACS组患者中合并高血压、吸烟、Lp-PLA2、CXCL16、中性粒细胞计数及NLR水平均升高,且差异有统计学意义(P㩳0.05)。而在年龄、性别、糖尿病、饮酒、TC、LDL方面未见明显差异(P㧐0.05)。通过回归分析结果显示:高血压、Lp-PLA2是ACS的危险因素。3)与稳定型斑块组相比,易损斑块组患者中高血压、吸烟率、LDL、Lp-PLA2、CXCL16、中性粒细胞计数及NLR水平均升高,且差异有统计学意义(P㩳0.05),而在年龄、性别、合并糖尿病、TC、HDL方面未见明显差异(P㧐0.05)。4)据不同Gensini积分水平分析发现:年龄、性别、高血压、吸烟、TC、Lp-PLA2、CXCL16、中性粒细胞计数及NLR在不同Gensini积分组间可见统计学差异(P㩳0.05),而在合并糖尿病、饮酒、LDL、HDL方面未见明显差异。Lp-PLA2、CXCL16、中性粒细胞计数及NLR均与高Gensini积分呈正相关。Lp-PLA2、中性粒细胞计数及NLR对高Gensini积分的预测上均有良好的曲线下面积,而CXCL16的曲线下面积欠佳。结论:本研究结果表明:1.合并高血压、Lp-PLA2是ACS危险因素,Lp-PLA2与斑块的易损性密切相关;2.CXCL16、NLR与ACS、斑块易损性相关;3.Lp-PLA2、中性粒细胞计数及NLR对ACS冠脉严重病变均有一定预测价值;4.Lp-PLA2对ACS冠脉严重病变预测性最佳,当大于5.95后预测高水平GS患者特异度、敏感度最佳。
[Abstract]:Objective: to analyze the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2), chemokine ligand 16 (CXCL16), neutrophil count, neutrophil / lymphocyte ratio (NLR) and severity of coronary artery disease in patients with acute coronary syndrome (ACS). Correlation of vulnerable plaques. Methods: 1) study subjects and groups: 224 patients with coronary heart disease diagnosed by CAG examination were selected from January 2016 to February 2017 in the Department of Cardiology, affiliated Hospital of Zunyi Medical College. The patients were divided into acute coronary syndrome (ACS) group and stable angina pectoris (SAP) group. There were 186 cases of ACS group (UA 75 cases, NSTEMI 52 cases, STEMI 59 cases), SAP 38 cases). According to the results of OCT, patients with OCT in ACS group were divided into vulnerable plaque (VP) group and stable plaque (SP) group, including VP group (9 cases) and SP group (8 cases). ACS group was divided into low level group (57 cases), moderate group (70 cases) and high level group (59 cases) according to Gensini score. The treated serum was stored in -80 鈩,
本文编号:2391695
[Abstract]:Objective: to analyze the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2), chemokine ligand 16 (CXCL16), neutrophil count, neutrophil / lymphocyte ratio (NLR) and severity of coronary artery disease in patients with acute coronary syndrome (ACS). Correlation of vulnerable plaques. Methods: 1) study subjects and groups: 224 patients with coronary heart disease diagnosed by CAG examination were selected from January 2016 to February 2017 in the Department of Cardiology, affiliated Hospital of Zunyi Medical College. The patients were divided into acute coronary syndrome (ACS) group and stable angina pectoris (SAP) group. There were 186 cases of ACS group (UA 75 cases, NSTEMI 52 cases, STEMI 59 cases), SAP 38 cases). According to the results of OCT, patients with OCT in ACS group were divided into vulnerable plaque (VP) group and stable plaque (SP) group, including VP group (9 cases) and SP group (8 cases). ACS group was divided into low level group (57 cases), moderate group (70 cases) and high level group (59 cases) according to Gensini score. The treated serum was stored in -80 鈩,
本文编号:2391695
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