冠状动脉慢血流患者血清Lp-PLA2、NLR水平变化及临床意义OACSTPCD
Changes in serum Lp-PLA2and NLR levels and their clinical significance in patients with coronary slow flow
目的 探讨冠状动脉慢血流(CSF)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)及中性粒细胞与淋巴细胞比值(NLR)的表达水平及其意义.方法 选取河北北方学院附属第一医院2022年12月至2023年8月经冠状动脉造影(CAG)检查确诊为CSF的患者45例作为观察组(CSF组),并选取同期行CAG检查结果提示冠状动脉血流正常的患者45例作为对照组.比较两组间血清Lp-PLA2和NLR水平差异;采用多因素logistic回归模型分析CSF发生人群的影响因素;绘制受试者工作特征(ROC)曲线,以评估血清Lp-PLA2 和NLR在诊断CSF发生方面的效能.结果 CSF组患者血清Lp-PLA2[(25.33±4.02)μg/L vs.(22.29±4.07)μg/L]、NLR[2.61(2.11,3.25)vs.1.54(1.19,1.86)]水平明显高于对照组(均 P＜0.05).多因素 logistic 回归提示,血清 Lp-PLA2 水平升高(OR=1.210,95％CI:1.015～1.442,P＜0.05)、NLR 水平升高(OR=35.826,95％CI:5.565～230.638,P＜0.01)是患者发生CSF的独立危险因素.进一步行ROC曲线分析结果表明,血清Lp-PLA2诊断CSF发生的临界值是23.127 μg/L,ROC曲线下面积(AUC)为0.699(95％CI:0.591～0.807,P＜0.05),敏感度0.756,特异度0.600.NLR 诊断 CSF 发生的临界值是 2.074,AUC为0.907(95％CI:0.845～0.969,P＜0.01),敏感度0.800,特异度0.911.两者联合诊断CSF发生的AUC为0.933(95％CI:0.884～0.982,P＜0.01),敏感度 0.867,特异度 0.889.结论 CSF 患者血清 Lp-PLA2 及NLR水平升高,两者均是影响CSF发生的独立危险因素,且对CSF有一定的诊断价值.
Objective To investigate the levels of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and the neutrophil-to-lymphocyte ratio(NLR)in patients with coronary slow flow(CSF)and their clinical signifi-cance.Methods From December 2022 through August 2023,45 patients with coronary slow flow verified by coronary angiography(CAG)at the First Affiliated Hospital of Hebei North University served as the observation group(CSF group).Simultaneously,45 individu This study included 45 patients diagnosed with CSF via coronary angiography(CAG)from December 2022 to August 2023 at the First Affiliated Hospital of Hebei North University as the observation group(CSF group).Another 45 patients with normal coronary blood flow indicated by CAG during the same period were selected as the control group.Serum Lp-PLA2 and NLR levels were compared between the two groups.A multivariate logistic re-gression model was used to analyze the influencing factors for CSF.Receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic efficacy of serum Lp-PLA2 and NLR for CSF.Results The levels of serum Lp-PLA2[(25.33±4.02)μg/L vs.(22.29±4.07)μg/L]and NLR[2.61(2.11,3.25)vs.1.54(1.19,1.86)]in the CSF group were significantly higher than those in the control group(both P＜0.05).Multivariate logistic regression indi-cated that elevated serum Lp-PLA2(OR=1.210,95％CI:1.015-1.442,P＜0.05)and NLR(OR=35.826,95％CI:5.565-230.638,P＜0.01)were independent risk factors for CSF.Further ROC curve analysis showed that the crit-ical value for diagnosing CSF with serum Lp-PLA2 was 23.127 µg/L,with an area under the ROC curve(AUC)of 0.699(95％CI:0.591-0.807,P＜0.05),sensitivity of 0.756,and specificity of 0.600.For NLR,the critical value for diagnosing CSF was 2.074,with an AUC of 0.907(95％CI:0.845-0.969,P＜0.01),sensitivity of 0.800,and specificity of 0.911.The AUS of the combined diagnosis of Lp-PLA2 and NLR was 0.933(95％CI:0.884-0.982,P＜0.01),with sensitivity of 0.867,and specificity of 0.889.Conclusion Elevated levels of serum Lp-PLA2 and NLR are observed in CSF patients,and both are independent risk factors for CSF.These markers have certain diagnostic value for CSF.
刘亚男;房志琴;郭健宏;王亚玲
河北北方学院附属第一医院心血管内科(河北张家口 075061)
临床医学
冠状动脉慢血流脂蛋白相关磷脂酶A2中性粒细胞与淋巴细胞比值
coronary slow flowneutrophil to lymphocyte ratiolipoprotein associated phospholipase A2
《广东医学》 2024 (006)
717-722 / 6
河北省医学科学研究课题(20200528)
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