稳定型冠心病合并糖尿病患者循环脂蛋白相关磷脂酶A2水平对左心功能的预测价值

陈运龙; 卞士柱; 刘小燕; 郭志念; 翁显贵; 王蓉; 王江

doi:10.13201/j.issn.1001-1439.2020.10.006

稳定型冠心病合并糖尿病患者循环脂蛋白相关磷脂酶A2水平对左心功能的预测价值

- 陆军军医大学(第三军医大学)第二附属医院心内科(重庆, 400037)
基金项目:
国家自然科学基金项目(No:81901916)

陆军军医大学第二附属医院临床科研课题(No:2015YLC11、20202017083)

详细信息

通讯作者: 王江,E-mail:1530579054@qq.com

中图分类号: R541.4

收稿日期: 2020-06-16

修回日期: 2020-08-15

Predictive value of circulating lipoprotein-related phospholipase A2 for left cardiac function in patients with stable coronary heart disease complicated with diabetes mellitus

- Department of Cardiology, Second Affiliated Hospital of Army Medical University, Third Military Medical University, Chongqing, 400037, China

More Information

Corresponding author: WANG Jiang, E-mail: 1530579054@qq.com

Received Date: 16 June 2020

Revised Date: 15 August 2020

摘要

摘要: 目的:探讨稳定型冠心病合并糖尿病患者循环脂蛋白相关磷脂酶A2(Lp-PLA2)水平对左心功能的预测价值。方法:选取2018年7月—2019年6月在陆军军医大学(第三军医大学)第二附属医院心内科因稳定型冠心病住院患者288例,按是否患有糖尿病分为冠心病合并糖尿病组(观察组,148例)和冠心病无糖尿病组(对照组,140例)。检测Lp-PLA2水平,并与左室射血分数(LVEF)及B型钠尿肽(BNP)作相关性分析。根据LVEF水平及中位BNP水平,将患者分为LVEF≥50%组和LVEF<50%组,以及BNP≥114.5 pg/ml组和BNP<114.5 pg/ml组,分别比较LVEF组间及BNP组间LP-PLA2水平的差异。结果:观察组空腹血糖、糖化血红蛋白、BNP、Lp-PLA2等均显著高于对照组,LVEF显著低于对照组(均P<0.05)。线性回归分析显示,观察组Lp-PLA2水平与LVEF水平呈负相关性(r=-0.308,P<0.01),Lp-PLA2水平与BNP水平呈正相关性(r=0.444,P<0.01);对照组不存在以上相关性。LVEF<50%组Lp-PLA2浓度显著高于LVEF≥50%组(P<0.05);Logistic多元回归分析显示,糖尿病史、肾小球滤过率、Lp-PLA2浓度是LVEF的危险因素(OR=2.065、0.983、1.005,均P<0.05)。BNP≥114.5 pg/ml组Lp-PLA2浓度显著高于BNP<114.5 pg/ml组(P<0.05);Logistic多元回归分析显示,BMI、肾小球滤过率、Lp-PLA2浓度是BNP的危险因素(OR=1.159、1.038、0.987,均P<0.05)。结论:稳定型冠心病合并糖尿病患者较无糖尿病患者心功能更差;循环Lp-PLA2水平是影响稳定型冠心病合并糖尿病患者左心功能的危险因素之一,对左心功能有一定的预测价值。
- 稳定型冠心病 /
- 糖尿病 /
- 脂蛋白相关磷脂酶A2 /
- 左心功能
Abstract: Objective: To explore the predictive value of circulating lipoprotein-associated phospholipase A2(Lp-PLA2) level for left ventricular function in patients with stable coronary heart disease complicated with diabetes mellitus. Method: A total of 288 inpatients admitted in the Department of Cardiology, Second Affiliated Hospital of the Third Military Medical University from July 2018 to June 2019 were included. All patients were divided into coronary heart disease complicated with diabetes group(observation group, n=148) and without diabetes group(control group, n=140). The levels of Lp-PLA2 were detected and the correlation with left ventricular ejection fraction(LVEF) and brain natriuretic peptide(BNP) was statistically analyzed. According to the LVEF level and median BNP level, all patients were divided into LVEF ≥ 50% group and LVEF<50% group, and BNP ≥ 114.5 pg/ml group and BNP<114.5 pg/ml group. Lastly, the levels of Lp-PLA2 between LVEF groups and BNP groups were compared. Result: The fasting blood glucose, HbA1 c, BNP and Lp-PLA2 in the observation group were significantly higher than those in the control group, while LVEF was significantly lower than that in the control group(all P<0.05). Linear regression analysis showed that Lp-PLA2 level was negatively correlated with LVEF level(r=-0.308, P<0.01) and was positively correlated with BNP level(r=0.444, P<0.01) in the observation group; while there was no above correlation in the control group. The concentration of LP-PLA2 in LVEF<50% group was significantly higher than that in LVEF≥50% group(P<0.05); Logistic multiple regression analysis showed that diabetes history, glomerular filtration rate and Lp-PLA2 concentration were risk factors for LVEF(OR=2.065, 0.983, 1.005, all P<0.05). The concentration of LP-PLA2 in BNP≥114.5 pg/ml group was significantly higher than that in BNP<114.5 pg/ml group(P<0.05); Logistic multiple regression analysis showed that BMI, glomerular filtration rate and Lp-PLA2 concentration were risk factors for BNP(OR=1.159, 1.038, 0.987, all P<0.05).Conclusion: Patients with stable coronary heart disease complicated with diabetes have worse cardiac function than those without diabetes. Circulating LP-PLA2 is one of the risk factors affecting left ventricular function in patients with stable coronary heart disease and diabetes, which has particular predictive value for the left ventricular function.
- stable coronary heart disease /
- diabetes /
- lipoprotein-associated phospholipase A2 /
- left cardiac function

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