文章摘要

脂蛋白相关磷脂酶A2对慢性心功能不全患者预后的评估价值

作者: 1史万青, 2韩志君, 3李莉, 1王三刚, 1沈童童, 1刘向前, 1刘玉, 1程昭栋, 1张涛, 1周利民
1 滁州市第一人民医院心内科,安徽 滁州 239000
2 无锡市第二人民医院检验科,江苏 无锡 214002
3 滁州市第一人民医院检验科,安徽 滁州 239000
通讯: 周利民 Email: 172498603@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.03.016
基金: 安徽省卫生和计划生育委员会项目 (2016QK091)。

摘要

目的:研究脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)与慢性心功能不全患者预后的关系。方法:回顾性分析2016年11月至2017年8月滁州市第一人民医院慢性心功能不全患者的病例资料,从中提取出患者就诊时的Lp-PLA2和其他临床特征。通过电话随访患者。采用受试者工作特征(receiver operation cur ve,ROC)曲线、Kaplan-Meier法和Cox风险比例模型分析Lp-PLA2与患者1年内死亡之间的关系。结果:共有150名慢性心功能不全患者进入研究,其中47例在1年内死亡。慢性心功能不全患者的Lp-PLA2水平随着NYHA分期的增高而逐渐增高。1年内死亡的慢性心功能不全患者Lp-PLA2水平显著高于1年内存活的患者。Lp-PLA2预测患者1年内死亡的ROC曲线下面积为0.75。在校正年龄、性别、NHYA分期、肌酐、高血压病史和N末端-B型利钠尿肽的Cox风险比例模型中,Lp-PLA2仍然与患者的预后独立相关。Lp-PLA2每增加20 ng/mL,患者的死亡风险比为1.14。结论:Lp-PLA2是慢性心功能不全患者的独立预后因子。
关键词: 心功能不全;脂蛋白相关磷脂酶A2;预后

Prognostic value of lipoprotein-associated phospholipase A2 in the prognosis of chronic heart failure

Authors: 1SHI Wanqing, 2HAN Zhijun, 3LI Li, 1WANG Sangang, 1SHEN Tongtong, 1LIU Xiangqian, 1LIU Yu, 1CHENG Zhaodong, 1ZHANG Tao, 1ZHOU Limin
1 Department of Cardiovascular Disease, First People’s Hospital of Chuzhou, Chuzhou Anhui 239000, China
2 Department of Laboratory Medicine, Wuxi No.2 People’s Hospital, Wuxi Jiangsu 214002, China
3 Department of Laboratory Medicine, First People’s Hospital of Chuzhou, Chuzhou Anhui 239000, China

CorrespondingAuthor: ZHOU Limin Email: 172498603@qq.com

DOI: 10.3978/j.issn.2095-6959.2019.03.016

Foundation: This work was supported by the Anhui Provincial Health and Family Planning Commission Project, China (2016QK091).

Abstract

Objective: To investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and prognosis of chronic heart failure. Methods: The medical records of chronic heart failure patients admitted to the First People’s Hospital of Chuzhou between November 2016 and August 2017 were retrospectively reviewed. Their Lp-PLA2 levels on admission were extracted. Subjects were followed up by telephone. The relationship between Lp-PLA2 and 1-year mortality of chronic heart failure was estimated by receiver operating characteristic (ROC) curve analysis, Kaplan-Meier curve and Cox model. Results: A total of 150 chronic heart failure patients were included in present study, and 47 of them died within 1 year after admission. Lp-PLA2 was significantly increased as the advance of NYHA grade. Subjects who died within 1 year had significantly higher Lp-PLA2 than those who was alive. The area under ROC curve of Lp-PLA2 for 1-year mortality was 0.74. After adjustment of age, gender, NYHA grade, creatine, hypertension and N-terminal pro B-type natriuretic peptide, Lp-PLA2 was independently associated with the prognosis of chronic heart failure, with a hazard ratio of 1.14 per 20 ng/mL. Conclusion: Lp-PLA2 is an independent prognostic factor for chronic heart failure.
Keywords: heart failure; lipoprotein-associated phospholipase A2; prognosis