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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

21卷

期数:

2015年04期

页码:

324-327

栏目:

临床医学

出版日期:

2015-07-15

文章信息/Info

Title:

Correlation between lipoprotein-associated phospholipase A2 levels and global registey of acute coronary event score in patients with acute coronary syndromes

文章编号:

1006-8147（2015）04-0324-04

作者:

孙丽丽; 李广平 ; 刘相丽; 刘洪梅; 倪燕萍

(天津医科大学第二医院心内科，天津300211)

Author(s):

SUN Li-li;  LI Guang-ping;  LIU Xiang-li;  LIU Hong-mei;  NI Yan-ping

(Department of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin 300211, China)

关键词:

急性冠脉综合征; 血清脂蛋白相关磷脂酶A2 ; 全球急性冠状动脉事件注册危险评分

Keywords:

acute coronary syndrome;  lipoprotein-associated phospholipase A2;  global registry of acute coronary events

分类号:

R541.4

DOI:

-

文献标志码:

A

摘要:

目的：探讨急性冠脉综合征(ACS)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)与全球急性冠状动脉事件注册(GRACE)评分的相关性，分析其对ACS患者住院期间发生主要不良心脏事件(MACE)的预测价值。方法：选取ACS患者257例，采用GRACE评分软件对患者进行风险评估并进行危险分层。所有入选患者住院期间进行ACS的常规治疗，观察MACE发生的情况。患者入院后24 h内采用免疫比浊法测定血清Lp-PLA2水平，并评价血清Lp-PLA2水平与GRACE评分及危险分层的关系。使用受试者工作曲线分析基线Lp-PLA2水平及GRACE评分对ACS患者住院期间发生MACE的曲线下面积，评估其预测价值。结果：ACS患者GRACE评分危险分层高危组(＞140分)Lp-PLA2水平显著高于中危组(109~140分)和低危组(≤108分）(P＜0.05)；中危组ACS患者Lp-PLA2水平高于低危组(P＜0.05)；将Lp-PLA2水平从低到高按四分位数分成Q1-Q4组，Q4组GRACE评分高于Q4以下组(P＜0.05)。进行双变量相关分析表明Lp-PLA2水平与GRACE评分呈正相关(r=0.737，P＜0.001)，受试者工作曲线基线Lp-PLA2水平及GRACE评分对ACS患者住院期间发生MACE的曲线下工作面积分别为0.771及0.785，两者比较差别无统计学意义。结论：ACS患者血清Lp-PLA2水平与GRACE评分呈正相关，Lp-PLA2对ACS患者进行早期危险度分层方面有一定价值；Lp-PLA2和GRACE评分均对ACS患者住院期间发生MACE的预测有较好价值。

Abstract:

Objective : To determine the correlation between lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and Global Registey of Acute Coronary Events (GRACE) risk score as well as risk stratification in patients with acute coronary syndrome (ACS),and to explore the clinical prognostic effect of Lp-PLA2 for major adverse cardiac events (MACE) in ACS patients. Methods: A total of 257 ACS patients were subjected to risk assessment and stratification with GRACE risk score. Data of all ACS patients received conventional treatments and MACE was recorded. Plasma Lp-PLA2 was measured by enzyme-linked immunosorbent assay and the relationship between plasma Lp-PLA2 level and GRACE scores in ACS patients was analyzed. Prediction accuracy of Lp-PLA2 level and GRACE risk score for MACE were determined by receiver operating characteristic curve and the corresponding area under the curve. Results: According to GRACE risk stratification, Lp-PLA2 level was significantly elevated in the high risk group (>140) compared with that in the middle risk group (109-140; P<0.05), while Lp-PLA2 level was significantly elevated in the middle risk group compared with that in the low risk group (≤108; P<0.05). According to the Lp-PLA2 level, patients were stratified into 4 groups by quartile (from the lowest to the highest, Q1-Q4). Compared with Q1-Q3 groups, the GRACE risk score and percentage of high risk patients were the highest in the Q4 group (P<0.05). Receiver operating characteristic curve analysis showed that Lp-PLA2 level was positively correlated with GRACE risk score and that the area under the curve of Lp-PLA2 level and GRACE risk score for predicting MACE in hospital patients were 0.771 and 0.785, respectively. Conclusion: Plasma Lp-PLA2 level is positively correlated with GRACE risk score. Both Lp-PLA2 level and GRACE risk score are valuable parameters to identify MACE in patients with ACS. Lp-PLA2 might be an important biomarker in the prognosis for ACS patients.

参考文献/References:

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[2] Chung H, Kwon H M, Kim J Y, et al. Lipoprotein-associated phospholipase A(2) is related to plaque stability and is a potential biomarker for acute coronary syndrome[J]. Yonsei Med J, 2014,55(6): 1507

[3] Tew D G, Southan C，Rice S Q，et al. Purification，properties，sequencing

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备注/Memo

备注/Memo:

作者简介 孙丽丽(1991-)，女，硕士在读，研究方向：心血管病学基础与临床；通信作者：刘相丽， E-mail：liuxl98@163.com。

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更新日期/Last Update: 2015-07-17