【摘要】 目的:分析白介素-6(IL-6)、C反应蛋白(CRP)、可溶性细胞间黏附分子-1(s ICAM-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)、载脂蛋白B(apo B)5项指标水平对于评估动脉粥样硬化(AS)及提高冠心病诊断准确率的价值。方法:纳入276例患者,分为急性冠脉综合征组(ACS)、稳定性心绞痛组(SAP)、无症状AS组及正常组,分析炎症5项及传统危险因素的各组间差异性及临床价值。结果:ACS组Lp-PLA2、CRP均较其余4组人群明显升高(P<0.05);多因素logistic回归分析显示Lp-PLA2与冠心病独立相关(OR=1.024,P<0.001),在传统危险因素诊断冠心病模型基础上加入CRP、Lp-PLA2水平使得整体χ2值明显升高;受试者工作特征曲线显示在传统危险因素基础上加入CRP、Lp-PLA2水平可使冠心病诊断灵敏度、特异度提升。结论:Lp-PLA2与冠心病斑块稳定性密切相关,Lp-PLA2与CRP水平对于在传统危险因素基础上提高冠心病诊断的准确性有重要价值。更多还原

【Abstract】 Objective To analyze the value of five biomarkers of inflammation, interleukin-6(IL-6), C reactive protein(CRP), soluble intercellular adhesion molecule-1(s ICAM-1), lipoprotein associated phospholipase A2(Lp-PLA2) and apolipoprotein B(apo B), for the evaluation of atherosclerosis and diagnosis of coronary heart disease(CHD). Methods 276 patients were divided into five groups : acute coronary syndrome(ACS group), stable angina pectoris(SAP group), asymptomatic atherosclerosis(AS group) and normal group. Five biomarkers of inflammation and traditional risk factors were analyzed to identify the difference within groups, so that clinical value can be evaluated. Results Lp-PLA2 and CRP of subjects in ACS group were significantly higher as compared with the other four groups(P < 0.05). Multivariate logistic regression analysis revealed that Lp-PLA2 levels are significantly independently associated with CHD(OR = 1.024, P < 0.001). The addition of CRP and Lp-PLA2 levels to CHD model significantly increased global χ2value over traditional risk factors. ROC curve indicated the addition of CRP and Lp-PLA2 levels can improve the sensitivity and specificity to diagnose CHD. Conclusions Elevated concentration of Lp-PLA2 is related with the degree of atherosclerosis, stability of plaques. The CRP and Lp-PLA2 levels show a great value for accurate diagnosis of CHD.更多还原