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目的人脂蛋白磷脂酶A_2在非ST段抬高急性冠状动脉综合征患者危险分层和预后评估中的作用。方法选取2013年1月至2014年12月间本院收治的经冠状动脉造影确诊的非ST段抬高急性冠状动脉综合征患者112例。根据TIMI危险积分将非ST段抬高急性冠状动脉综合征患者分为:高分组(6~7分)31例、中分组(2~5分)42例、低分组(0~1分)39例。采用酶联免疫吸附法测定人脂蛋白磷脂酶A_2浓度,记录体质量指数、TC、TG、HDL-C、LDL-C等临床指标,患者出院后追踪1个月内主要心血管事件发生情况。结果非ST段抬高急性冠状动脉综合征患者TC、TG、LDL-C、蛋白磷脂酶A_2值明显高于对照组,HDL-C明显低于对照组(P<0.05)。经Speraman分析显示,蛋白磷脂酶A_2浓度与TC、LDL-C之间呈明显正相关;蛋白磷脂酶A2浓度与HDL-C之间呈明显负相关。以非ST段抬高急性冠状动脉综合征为因变量,Logistic回归分析显示,非ST段抬高急性冠状动脉综合征与蛋白磷脂酶A_2、LDL-C、HDL-C之间相关。随访1个月中,TIMI高分组、中分组心血管不良事件总发生率与低分组相比明显增加(P<0.05);其中高分组病死率、心力衰竭率明显高于中分组和低分组(P<0.05)。结论人脂蛋白磷脂酶A2能够独立预测冠状动脉事件的发生风险,具有较高的特异性,可用于非ST段抬高急性冠状动脉综合征的危险分层和早期诊断。
Role of human lipoprotein lipase A2 in risk stratification and prognosis assessment of patients with non-ST segment elevation acute coronary syndrome. Methods One hundred and twelve patients with non-ST segment elevation acute coronary syndrome confirmed by coronary angiography in our hospital from January 2013 to December 2014 were selected. According to the TIMI risk score, patients with non-ST segment elevation acute coronary syndrome were divided into three groups: high-grade group (6 to 7), middle-grade group (2-5), low-grade group (0 to 1) example. Serum lipoprotein lipase A2 concentration was measured by enzyme-linked immunosorbent assay. The body mass index, TC, TG, HDL-C, LDL-C and other clinical indicators were recorded. The patients were followed up for major cardiovascular events within 1 month after discharge. Results The levels of TC, TG, LDL-C and phospholipase A 2 in patients with non-ST segment elevation acute coronary syndrome were significantly higher than those in control group, and HDL-C was significantly lower than that in control group (P <0.05). Speraman analysis showed that the concentration of phospholipase A2 was positively correlated with TC and LDL-C, while the concentration of phospholipase A2 was negatively correlated with HDL-C. Non-ST-elevation acute coronary syndrome as a dependent variable, Logistic regression analysis showed that non-ST-segment elevation acute coronary syndrome and phospholipase A 2, LDL-C, HDL-C between the correlation. One month after follow-up, the overall incidence of adverse cardiovascular events in TIMI high and middle groups was significantly higher than that in the low group (P <0.05). The high group mortality and heart failure rate were significantly higher than those in the middle group and the low group P <0.05). Conclusions Human lipoprotein phospholipase A2 can independently predict the risk of coronary events and is of high specificity and can be used for risk stratification and early diagnosis of non-ST segment elevation acute coronary syndrome.