同型半胱氨酸、脂蛋白a及脂蛋白磷脂酶A2联合检测对冠心病的诊断价值*

doi:10.3969/j.issn.1671-2587.2019.06.001

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (6): 561-563.DOI: 10.3969/j.issn.1671-2587.2019.06.001

• 临床检验 • 下一篇

同型半胱氨酸、脂蛋白a及脂蛋白磷脂酶A2联合检测对冠心病的诊断价值^*

杨玉萍, 杨旭东

213300 江苏省常州市溧阳市中医医院检验科

收稿日期:2018-06-14 出版日期:2019-12-20 发布日期:2019-12-25
作者简介:杨玉萍（1977-）,女,副主任技师,学士,主要从事临床检验工作,（Tel）13915859712（E-mail）yamoacf@163.com。
基金资助:
*本课题受国家高技术研究发展计划（863计划）子课题（No. 2014AA022304）资助

The Value of Combined Determination of Homocysteine,Lipoprotein （a） and Lipoprotein Phospholipase A2 in the Diagnosis of Coronary Heart Disease

YANG Yu-ping, YANG Xu-dong

Department of Laboratory Medicine,Liyang Hospital of Traditional Chinese Medicine,Jiangsu 213300

Received:2018-06-14 Online:2019-12-20 Published:2019-12-25

摘要/Abstract

摘要： 目的探讨血清同型半胱氨酸（Hcy）、脂蛋白a（LPa）联合脂蛋白磷脂酶A2（LP-PLA2）检测对冠心病的诊断价值。方法选择2016年3月~2018年3月本院收治的冠心病患者214例为观察组,根据患者疾病类型选择82例急性心肌梗死患者为A组,74例稳定型心绞痛患者为B组,58例不稳定型心绞痛患者为C组;再选择同期本院住院的无冠心病患者180例为对照组。检测各组血清Hcy、LPa、LP-PLA2水平,并进行比较;对比单项指标与联合检测的阳性率,同时比较各组血清Hcy、LPa、LP-PLA2指标测定值范围。结果 A、B、C组单纯血清Hcy、LPa、LP-PLA2检测及联合检测阳性率均高于对照组,差异有统计学意义（P<0.05）;A、C组单纯血清Hcy、LPa、LP-PLA2检测及联合检测阳性率高于B组,差异有统计学意义（P<0.05）;A、B、C组血清Hcy、LPa、LP-PLA2联合检测阳性率高于单纯血清Hcy、LPa、LP-PLA2检测,差异有统计学意义（P<0.05）;A组血清Hcy水平高于B组、对照组,差异有统计学意义（P<0.05）;A、B、C组LPa、LP-PLA2水平均高于对照组,差异有统计学意义（P<0.05）;A、B、C组的LPa水平存在明显界线,B、C组的LP-PLA2水平存在明显界线。结论血清Hcy、LPa、LP-PLA2水平联合检测对冠心病诊断具有应用价值,其中LPa和LP-PLA2水平可有效区分冠心病类型,值得推广。

关键词: 同型半胱氨酸, 脂蛋白a, 脂蛋白磷脂酶A2, 冠心病诊断

Abstract: Objective To investigate the diagnostic value of serum homocysteine （Hcy）,lipoprotein a （LPa） and lipoprotein phospholipase A2 （LP-PLA2） detection in coronary heart disease. Methods A total of 214 CHD patients admitted to our hospital from March 2016 to March March 2018 were selected as observation group. According to the disease type,82 patients with acute myocardial infarction were treated as group A and 74 patients with stable angina were treated as group B. 58 Cases with unstable angina were treated as group C,and another 180 patients without coronary heart disease in our hospital during the same period were selected as control group. Serum levels of Hcy,LPa,and LP-PLA2 were measured in each group,and comparative analysis was performed. The positive rates of single-marker detection and combined detection were compared. The range of serum Hcy,LPa,and LP-PLA2 indicators was also compared in each group.Results The positive rates of serum Hcy,LPa,and LP-PLA2 detection and combined detection in group A,B,and C were higher than those in the control group,and the difference was statistically significant （P<0.05）. The levels of serum Hcy,LPa,and LP-PLA2 were positive and positive in the groups A and C. The rate was higher in group B than in group B （P<0.05）. The positive rates of serum Hcy,LPa,and LP-PLA2 in group A,B,and C were higher than those in serum Hcy,LPa,and LP-PLA2 alone. Statistical significance （P<0.05）; Serum Hcy level in group A was higher than that in group B and control group,the difference was statistically significant （P<0.05）; LPA,LP-PLA2 levels in group A,B,and C were higher than those in control group The difference was statistically significant （P<0.05）; there was a clear line between the LPA levels in the A,B,and C groups,and there was a clear line between the LP-PLA2 levels in the B and C groups.Conclusion The combined detection of serum Hcy,LPa,and LP-PLA2 levels has significant value in the diagnosis of coronary heart disease. LPa and LP-PLA2 levels can effectively distinguish the type of coronary heart disease,and it is worth promoting.

Key words: Homocysteine, Lipoprotein a, Lipoprotein phospholipase A2, Diagnosis of coronary heart disease

中图分类号:

杨玉萍, 杨旭东. 同型半胱氨酸、脂蛋白a及脂蛋白磷脂酶A2联合检测对冠心病的诊断价值^*[J]. 临床输血与检验, 2019, 21(6): 561-563.

YANG Yu-ping, YANG Xu-dong. The Value of Combined Determination of Homocysteine,Lipoprotein （a） and Lipoprotein Phospholipase A2 in the Diagnosis of Coronary Heart Disease[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2019, 21(6): 561-563.

参考文献

1 王伍支,宋英.Hcy、hs-CRP及脂蛋白水平在老年冠心病病人中的诊断价值及应用[J].中西医结合心脑血管病杂志,2017,15(7):836-838.
2 谭祥地,林嘉隆.血浆脂蛋白相关性磷脂酶A2水平在冠心病患者诊断中的价值[J]. 心肺血管病杂志,2017,36(6):454-457.
3 Radovica-Spalvina I,Latkovskis G,Silamikelis I,et al.Next-generation-sequencing-based identification of familial hypercholesterolemia-related mutations in subjects with increased LDL-C levels in a latvian population[J].BMC Med Genet,2015,16(1):86.
4 Pan L,Lu G,Chen Z.Combined use of apolipoprotein B/apolipoprotein A1 ratio and non-high-density lipoprotein cholesterol before routine clinical lipid measurement in predicting coronary heart disease[J].Coron Artery Dis,2014,25(5):433-438.
5 胥良.同型半胱氨酸和脂蛋白联合检测在冠心病诊断中的临床意义[J].实用中西医结合临床,2017,17(6):93-94.
6 古杰超,冯秀兰,范修敬.脂蛋白相关磷脂酶A2与缺血修饰白蛋白在冠心病诊断中的表达与相关性[J].实用检验医师杂志,2017,9(1):34-36.
7 卢群,张笈,田刚,等.各血脂指标与高密度脂蛋白胆固醇比值对冠心病的诊断价值[J].山西医科大学学报,2017,48(9):883-886.
8 许帅元,邱金娥,李宏.脂蛋白(a)、血脂、尿酸联合检测在青龙满族自治县居民冠心病的诊断价值[J].国际检验医学杂志,2017,38(18):2513-2516.
9 Wei L,Liu S,Su Z,et al.LINE-1 hypomethylation is associated with the risk of coronary heart disease in Chinese population[J].Arq Bras Cardiol,2014,102(5):481-488.
10 刘季晨,郭凯,卢浩,等.红细胞分布宽度联合脂蛋白相关磷脂酶A2检测可提高冠心病患者的冠状动脉狭窄程度诊断的准确性[J].南方医科大学学报,2016,36(6):875-879.
11 盘荣棠.高敏C反应蛋白和脂蛋白(a)联合检测在冠心病诊断中的应用[J].国际医药卫生导报,2015,21(4):528-529.
12 G ouchowska A,R bowska E,Drygas W,et al.Metabolic risk in men with ischaemic heart disease and their participation in ambulatory comprehensive cardiac rehabilitation[J].Kardiol Pol,2015,73(8):656-663.
13 Hargens T A,Rhodes P G,VanReenen J,et al.Lipoprotein-associated phospholipase A2 and carotid intima-media thickness in individuals classified as low-risk according to Framingham[J].Cardiovasc Diagn Ther,2014,4(6):487-494.
14 鲍巧玲.血清CRP、Hcy、LP(a)、D-二聚体联合检测对冠心病的临床诊断价值[J].国际检验医学杂志,2018,39(1):77-79.
15 黄燕春.冠心病联合检测同型半胱氨酸、脂蛋白(a)及D-二聚体的意义[J].包头医学院学报,2018,34(3):58-59.
16 任聪慧,孙经武,刘成洲,等.冠心病合并糖尿病患者脂蛋白(a)和同型半胱氨酸及胱抑素C水平变化的研究[J].中华老年心脑血管病杂志,2017,19(7):1264-1267.
17 Yang S H,Li Y T,Du D Y.Oxidized low-density lipoprotein-induced CD147 expression and its inhibition by high-density lipoprotein on platelets in vitro[J]. Thromb Res,2013,132(6):702-711.
18 赵晓萌,高雷,刘勇.血清同型半胱氨酸与超敏肌钙蛋白T联合检测在冠状动脉粥样硬化性心脏病诊断中的应用[J].中国医科大学学报,2017,46(1):59-61.

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同型半胱氨酸、脂蛋白a及脂蛋白磷脂酶A2联合检测对冠心病的诊断价值^*

The Value of Combined Determination of Homocysteine,Lipoprotein （a） and Lipoprotein Phospholipase A2 in the Diagnosis of Coronary Heart Disease

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