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《Chinese Journal of Difficult and Complicated Cases》 2016-01
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Changes of serum lipoprotein phospholipase A2 and its clinical significance in acute coronary syndrome patients with PCI

ZOU Ling;YAN Zhenming;LI Xiaozhen;SONG Yaofeng;HE Fang;Department of Cardiology,General Hospital of Fushun Mining Bureau of Liaoning Province;  
Objective To analyze the changes of serum lipoprotein phospholipase A2(Lp-PLA2) and its clinical significance in acute coronary syndrome(ACS) patients with percutaneous coronary intervention(PCI).Methods Fiona January 2013 to June 2014,80 cases of ACS patients were selected as ACS group,according to the different types,they were divided into unstable angina pectoris(UAP) subgroup with 32 cases,non ST segment elevation myocardial infarction(NSTEMI) subgroup of 28 patients,ST segment elevation myocardial infarction(STEMI) subgroup of 20 patients;according to the Gensini score,they were divided info mild subgroup(Gensini score≤20 points) with 36 cases,moderate subgroup(20 points Gensini score ≤40 points) with 90 cases,severe subgroup(Gensini score 40) with 34 cases.Selected the same period of non-coronary heart disease patients(40 cases) enrolled as the control group.Analyzed the correlation between preoperative and postoperative Lp-PLA2 changes and major adverse events(MACE).Results(1) Lp-PLA2:before PCI,ACS group's level of serum Lp-PLA2 were significantly higher than those of the control group(F =4.198,P =0.027),STEMI subgroup was higher than UAP subgroup(t = 1.944,P = 0.030).Compared with the preoperative,postoperative STEMI subgroup's serum Lp-PLA2 decreased significantly(t =2.016,P =0.026).Preoperative moderate subgroup and severe subgroup's levels of Lp-PLA2 were significantly higher than that of mild subgroup(P 0.05),after PCI,severe subgroup's Lp-PLA2 was decreased significantly compared to the preoperative(P 0.05).(2) Gensini score;STEMI subgroup was higher than that of UAP subgroup(P 0.05) and severe subgroup was obviously higher than mild subgroup(P 0.05).(3) Occurrence of MACE rate:different types of patients' MACE rate showed statistically significant differences(P 0.05);the extent of coronary artery disease in severe subgroup was different from mild subgroup,the difference showed statistical significance(P 0.05).(4) ROC curve analysis:preoperative,△(preoperative and postoperative) 's level of Lp-PLA2 and Gensini scores had certain diagnostic predictive value for MACE occurrence(P 0.05).(5) Correlation analysis:preoperative level of Lp-PLA2 and MACE were positively correlated(r =0.622,P =0.014),△(preoperative and postoperative)and mace was negative correlated(r =-0.653,P =0.011).Gensini score greater than 61.6 and △(preoperative postoperative) greater than 20.2 was independent risk factors for MACE.Conclusion The Lp-PLA2 in patients with ACS was significantly higher,and after PCI,it was declined.Gensini score and A(preoperative postoperative) can be used as independent risk factors for MACE.
【CateGory Index】: R541.4
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