Application of Lipoprotein-associated Phospholipase A2 in Coronary Heart Disease Patients Taking Statins
-
摘要:
目的 探讨磷脂酶相关脂蛋白A2(Lp-PLA2)作为冠心病患者服用他汀类药物疗效监测指标的适用性。 方法 采用回顾性分析方法,用队列设计研究,选取到云南新昆华医院就诊的冠心病患者58例,分为2组:服用他汀类药物的29例冠心病患者为观察组;未服用他汀类药物的29例冠心病患者为对照组。观察组和对照组,性别、青年和中老年、有无糖尿病及有无吸烟等,差异无统计学意义(P > 0.05);对2组患者的Lp-PLA2进行比较和分析,并评估相关因素对Lp-PLA2的影响。 结果 观察组的总体Lp-PLA2 [139.6(94.0,181.1)ng/mL]低于对照组[278.6(207.0,358.3)ng/mL],差异有统计学意义(P < 0.001)。 结论 Lp-PLA2可作为冠心病患者服用他汀类药物疗效监测的有效指标。 -
关键词:
- 阿托伐他汀 /
- 瑞舒伐他汀 /
- 冠心病 /
- 磷脂酶相关脂蛋白A2
Abstract:Objective To investigate the applicability of lipoprotein-associated phospholipase A2 (Lp-PLA2) as an indicator for effectiveness in patients with coronary heart disease taking statins. Methods Retrospective analysis and cohort design were used to study 58 patients with coronary heart disease who were admitted to Xinkunhua Hospital in Yunnan province. They were divided into two groups: 29 patients with coronary heart disease who were taking statins as the observation group; 29 patients with coronary heart disease who did not take statins were the control group. There were no significant differences between the observation group and the control group in gender, age, incidence of diabetes and smoking (P > 0.05). Lp-pla2 in the two groups was compared and analyzed, and the influence of related factors on LP-PLA2 was evaluated. Results The overall Lp-PLA2 [139.6 (94.0, 181.1) ng/mL] of the observation group is significantly lower than that of the control group [278.6 (207.0, 358.3) ng/mL] (P < 0.001). Conclusion Lp-PLA2 can be used as an effective indicator for monitoring the efficacy of statins of ASCVD. -
Key words:
- Atorvastatin /
- Rosuvastatin /
- Coronary heart disease(CHD) /
- Lp-PLA2
-
表 1 2组研究对象的临床资料对比[n(%)]
Table 1. Comparison of clinical information between the two groups [n(%)]
组别 n 男 青年人 高血压 糖尿病 吸烟 对照组 29 23(79.3) 19(65.5) 14(48.3)* 9(31.0) 19(65.5) 观察组 29 24(82.8) 12(41.4) 22(75.7) 13(44.8) 19(65.5) χ2 1.000 0.113 0.057 0.417 1.000 P 0.500 0.057 0.029 0.209 0.609 0~17岁为未成年人,18~65岁为青年人,66~79岁为中年人,80~99岁为老年人。与对照组比较,*P < 0.05。 表 2 不同性别的Lp-PLA2比较[M(P25,P75)]
Table 2. Comparison of Lp-PLA2 of different genders[M(P25,P75)]
组别 男 女
Z
P对照组(ng/mL) 279.6
(225.4,347.1)234.8
(179.4,398.1)−1.023 0.306 观察组(ng/mL) 142.0
(095.3,183.8)095.5
(077.8,194.5)−0.635 0.525 表 3 不同年龄段的Lp-PLA2比较[M(P25,P75)]
Table 3. Comparison of Lp-PLA2 in different age groups[M(P25,P75)]
组别 青年人 中老年人 Z
P对照组
(ng/mL)297.7
(206.4,409.3)263.5
(204.0,285.3)−1.560 0.119 观察组
(ng/mL)145.9
(095.8,185.1)137.1
(77.9,181.1)−0.753 0.452 表 4 有无高血压的Lp-PLA2比较[M(P25,P75)]
Table 4. Comparison of Lp-PLA2 with or without hypertension [M(P25,P75)]
组别有高血压 没有高血压
Z
P对照组
(ng/mL)287.7
(221.0,398.1)274.1
(205.5,312.3)−0.873 0.383 观察组
(ng/mL)143.5
(094.3,194.6)96.8
(089.7,168.1)−0.968 0.333 表 5 对照组有无糖尿病的Lp-PLA2比较[M(P25,P75)]
Table 5. Comparison of Lp-PLA2 with or without diabetes in the control group [M(P25,P75)]
组别 有糖尿病 没有糖尿病
Z
P对照组
(ng/mL)271.3
(216.5,401.8)287.7
(205.7,357.4)−0.873 0.383 表 6 观察组有无糖尿病的Lp-PLA2比较 (
$\bar x \pm s $ )Table 6. Comparison of Lp-PLA2 with or without diabetes in the observation group (
$\bar x \pm s $ )组别 有糖尿病 没有糖尿病 t P 观察组
(ng/mL)129.0±53.8 161.5±82.3 0.734 0.399 表 7 是否吸烟的Lp-PLA2比较[M(P25,P75)]
Table 7. Comparison of Lp-PLA2 for smoking or not [M(P25,P75)]
组别 吸烟 不吸烟
Z
P对照组
(ng/mL)279.6
(207.6,369.4)194.9
(143.6,355.0)−0.780 0.435 观察组
(ng/mL)144.4
(94.9,186.6)128.5
(78.2,183.7)−0.413 0.680 表 8 Lp-PLA2对他汀类药物疗效监测的作用[M(P25,P75)]
Table 8. The effect of Lp-PLA2 on monitoring the efficacy of statins [M(P25,P75)]
项目 对照组 观察组
Z
Pn 29 29 − − Lp-PLA2(ng/mL) 278.6(207.0,358.3) 139.6(94.0,181.1) −5.412 < 0.001 -
[1] 中国心血管健康与疾病报告编写组.中国心血管健康与疾病报告2019概要 [J]. 中华老年病研究电子杂志, 2020, 7(4): 4-15. [2] Bueke J E,Dennis E A. Phospholipase A2 biochemistry[J]. Cardiovascular Drugs and Therapy,2009,23(1):49-59. doi: 10.1007/s10557-008-6132-9 [3] 费菲. 最新解读《脂蛋白相关磷脂酶A2临床应用中国专家建议》——第26届长城国际心脏病学会议(GW-ICC)暨亚太心脏大会201现场回顾[J]. 中国医药科学,2015,5(21):4-8. [4] Wang Y,Yee A J,SirardC,et al. Sodium fluoride PET imaging as a quantitative pharmacodynamic biomarker for bone homeostasis during anti-DKK1 therapy for multiple myeloma[J]. Blood Cancer Journal,2017,7(10):615. doi: 10.1038/bcj.2017.95 [5] Brilakis E S,Khera A,Mcguire D K,et al. Influence of race and sex on lipoprotein-associated phospholipase A2 levels:observations from the Dallas Heart Study[J]. Atherosclerosis,2008,199(1):110-115. doi: 10.1016/j.atherosclerosis.2007.10.010 [6] Heller D J,Coxson P G,Penko J,et al. Evaluating the impact and cost-effectiveness of statin use guidelines for primary prevention of coronary heart disease and stroke[J]. Circulation,2017,136(12):1087-1098. doi: 10.1161/CIRCULATIONAHA.117.027067 [7] 张恒亮,张培,陈润,等. 脂蛋白相关磷脂酶A2水平对急性冠脉综合征患者预后的预测价值研究[J]. 实用医院临床杂志,2020,17(6):212-215. [8] 周菊芬,蔡卫平. 动脉粥样硬化性脑梗死中的脂蛋白磷脂酶A2检测的临床价值研究[J]. 系统医学,2021,6(6):55-57. [9] Wang R,Wang X,Zhang E,et al. Correlation of plasma galectin-3 and plasma lipoprotein-associated phospholipase A2 with the severity and prognosis of coronary artery disease[J]. American Journal of Translational Research,2021,13(8):8997-9004. [10] 张正生,谢冠聪,黄彩艳. 脂蛋白相关磷脂酶A2在急性冠脉综合征早期预警作用的研究[J]. 当代医学,2021,27(10):129-132. doi: 10.3969/j.issn.1009-4393.2021.10.051 [11] 姜建强. 瑞舒伐他汀与阿托伐他汀对早发冠心病急性心肌梗死患者的近期疗效[J]. 中西医结合心血管病电子杂志,2020,8(4):41. [12] 陈颖. 瑞舒伐他汀和阿托伐他汀治疗冠心病的临床疗效及应用价值比较分析[J]. 中国保健营养,2021,31(4):276-277. [13] 孙彦彦. 脂蛋白相关磷脂酶A2与冠心病的关系及不同剂量阿托伐他汀的治疗作用 [D]. 郑州: 郑州大学硕士论文, 2010.