摘要
目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)对老年高血压患者冠状动脉粥样硬化性心脏病(简称冠心病)的预测价值。方法选取2020年4月-2023年5月西安交通大学第一附属医院东院区收治的高血压并发冠心病患者68例为冠心病组,91例单纯高血压患者为非冠心病组,记录患者临床资料及实验室指标,患者均行冠状动脉造影检查,根据Gensini评分将冠心病组患者分为轻中度组(35例)与重度组(33例)。采用logistic回归模型分析各变量与冠心病的发生、严重程度的关系;采用ROC曲线分析各变量预测冠心病的发生、严重程度的效能。结果冠心病组高血压病程≥5年患者比例、低密度脂蛋白胆固醇、血管紧张素Ⅱ、载脂蛋白B、Lp-PLA2高于非冠心病组(P<0.05),载脂蛋白A1低于非冠心病组(P<0.05)。logistic回归分析显示,高血压病程≥5年、Lp-PLA2均是预测高血压并发冠心病的独立危险因素(P<0.05)。Lp-PLA2预测高血压并发冠心病的AUC值为0.740(95%CI:0.672~0.809,P<0.001)。重度组病程≥5年患者的比例、吸烟患者的比例、血管紧张素Ⅱ及Lp-PLA2水平均高于轻中度组(P<0.05)。logistic回归分析显示,Lp-PLA2是预测高血压并发重度冠心病的独立危险因素(P<0.05)。Lp-PLA2预测高血压并发重度冠心病的AUC值为0.821(95%CI:0.719~0.923,P<0.001)。结论老年高血压患者血清Lp-PLA2水平对冠心病的发生、严重程度有一定的预测价值。
Objective To investigate the predictive value of lipoprotein-associated phospholipase A2(Lp-PLA2)on coronary atherosclerotic heart disease(abbreviated as coronary heart disease)in elderly patients with hypertension.Methods A total of 68 coronary heart disease patients with hypertension admitted to the East Campus of Xi'an Jiaotong University First Affiliated Hospital from April 2020 to May 2023 were selected as the coronary heart disease group,while another 91 patients with pure hypertension were selected as the non-coronary heart disease group.Clinical data and laboratory indicators of the patients were recorded.All patients underwent coronary angiography,and patients in the coronary heart disease group were divided into the mild-to-moderate group(35 cases)and the severe group(33 cases)based on the Gensini score.Logistic regression model analysis was used to examine the relationship between various variables and the occurrence and severity of coronary heart disease,while ROC curves were employed to analyze the predictive efficiency of these variables in terms of the occurrence and severity of coronary heart disease.Results The proportion of patients with hypertension duration≥5 years,low-density lipoprotein cholesterol,angiotensinⅡ,apolipoprotein B,and Lp-PLA2 were higher in the coronary heart disease group compared to the non-coronary heart disease group(P<0.05),while apolipoprotein A1 was lower(P<0.05).Logistic regression analysis revealed that hypertension duration≥5 years and Lp-PLA2 were independent risk factors for predicting hypertension with coronary heart disease(P<0.05).The AUC value of Lp-PLA2 for predicting hypertension with coronary heart disease was 0.740(95%CI:0.672-0.809,P<0.001).In the severe group,the proportion of patients with disease duration≥5 years,the proportion of smokers,angiotensinⅡ,and Lp-PLA2 were higher than those in the mild-to-moderate group(P<0.05).logistic regression analysis showed that Lp-PLA2 was an independent risk factor for predicting hypertension with severe coronary heart disease(P<0.05).The AUC value of Lp-PLA2 for predicting hypertension with severe coronary heart disease was 0.821(95%CI:0.719-0.923,P<0.001).Conclusion The serum Lp-PLA2 level in elderly patients with hypertension has a certain predictive value for predicting the occurrence and severity of coronary heart disease.
作者
张咪咪
樊蓉
Zhang Mimi;Fan Rong(Department of Cardiovascular Medicine,East Campus of Xi'an Jiaotong University First Affiliated Hospital,Xi'an 710089)
出处
《国际老年医学杂志》
2025年第2期150-155,共6页
International Journal of Geriatrics
关键词
脂蛋白相关磷脂酶A2
高血压
冠状动脉粥样硬化性心脏病
冠状动脉病变程度
Lipoprotein-associated phospholipase A2
Hypertension
Coronary atherosclerotic heart disease
Degree of coronary artery disease
作者简介
通信作者:樊蓉,电子邮箱284111962@qq.com。
