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
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