本文選題：脂蛋白相關(guān)磷脂酶A2 + 缺血修飾性白蛋白��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:近來,脂蛋白相關(guān)磷脂酶A2(LP-PLA2)受到越來越多心血管專家的關(guān)注,其被認(rèn)為是與心肌損傷密切相關(guān)的生化指標(biāo),故本實(shí)驗(yàn)通過檢測(cè)急性冠脈綜合征(ACS)患者血清中LP-PLA2的含量變化,探討LP-PLA2在ACS診斷的臨床應(yīng)用價(jià)值。因胸痛發(fā)作至入院時(shí)間不同,分析比較不同時(shí)間入院的ACS患者LP-PLA2濃度變化及其陽性率,探討LP-PLA2,IMA,c Tn I三種生化指標(biāo)優(yōu)缺點(diǎn)及聯(lián)合檢測(cè)的意義。ACS患者體內(nèi)伴隨炎癥反應(yīng),氧化應(yīng)激增強(qiáng),故統(tǒng)計(jì)分析LP-PLA2與hs CRP、氧化應(yīng)激指標(biāo)以及脂類生化指標(biāo)(ACS的高危因素)的相關(guān)性。方法:收集2015年8月至2016年7月在吉林大學(xué)第一醫(yī)院急診內(nèi)科和心內(nèi)科住院并且臨床資料完整的經(jīng)過冠狀動(dòng)脈造影、心電圖以及臨床癥狀和體征已確診為ACS患者血液標(biāo)本153例作為實(shí)驗(yàn)組,按出現(xiàn)胸痛至入院時(shí)間的不同分為Ⅰ組(3 h)57例、Ⅱ組(3-6h)42例和Ⅲ組(6 h)54例。收集同期來自吉林大學(xué)第一醫(yī)院體檢中心的健康體檢者血液標(biāo)本50例為對(duì)照組,分別進(jìn)行血清LP-PLA2、IMA、c Tn I、hs CRP、CHO、TG、LDLC、HDLC、APOA1、APOB、SOD和TAS檢測(cè),進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.實(shí)驗(yàn)組血清LP-PLA2、IMA、c Tn I、hs CRP均明顯的高于對(duì)照組(p0.05),TAS、SOD明顯低于對(duì)照組(p0.05),差異具有統(tǒng)計(jì)學(xué)意義。2.除實(shí)驗(yàn)Ⅲ組中IMA,實(shí)驗(yàn)Ⅰ組中c Tn I與對(duì)照組比較無統(tǒng)計(jì)學(xué)意義(p0.05)外,實(shí)驗(yàn)Ⅰ、Ⅱ、Ⅲ組中LP-PLA2、IMA、c Tn I、TAS、SOD、hs CRP各項(xiàng)指標(biāo)分別與對(duì)照組比較,均升高明顯(p0.05)。TAS、SOD、hs CRP三項(xiàng)指標(biāo)分別在不同實(shí)驗(yàn)組間兩兩比較差異無統(tǒng)計(jì)學(xué)意義(p0.05),LP-PLA2、IMA、c Tn I三項(xiàng)指標(biāo)在不同實(shí)驗(yàn)組間兩兩比較差異有統(tǒng)計(jì)學(xué)意義(p0.05)。3.實(shí)驗(yàn)Ⅰ、Ⅱ、Ⅲ組LP-PLA2、IMA、c Tn I陽性率與三項(xiàng)指標(biāo)聯(lián)合檢測(cè)陽性率之間的比較差異有統(tǒng)計(jì)學(xué)意義(p0.05)。4.LP-PLA2與TG(r=0.951,p0.01)、CHO(r=0.961,p0.01)、LDLC(r=0.902,p0.01)、APOB(r=0.935,p0.01)、hs CRP(r=0.48,0.01p0.05)呈正相關(guān);與HDLC(r=0.03,p0.01)、APOA1(r=0.112,p0.01)無相關(guān)性;與SOD(r=-0.689,p0.01)、TAS(r=-0.75,p0.01)呈負(fù)相關(guān)。結(jié)論:1.LP-PLA2濃度在ACS患者血清中升高,且在早期明顯升高。2.LP-PLA2特異度明顯高于IMA,其靈敏度顯著優(yōu)于c Tn I,與IMA、c Tn I聯(lián)合檢測(cè)能夠更好地輔助臨床對(duì)ACS的診斷。3.LP-PLA2與CHO、TG、LDLC、APOB、hs CRP呈正相關(guān);LP-PLA2與SOD、TAS呈負(fù)相關(guān)。
[Abstract]:Objective: Recently, lipoprotein related phospholipase A2 (LP-PLA2) is concerned by more and more cardiovascular experts. It is considered to be a biochemical marker closely related to myocardial injury. Therefore, the clinical application value of LP-PLA2 in the diagnosis of ACS was explored by detecting the changes of the serum LP-PLA2 content in the patients with acute coronary syndrome (ACS). The clinical value of LP-PLA2 in the diagnosis of ACS was discussed. The changes in the concentration of LP-PLA2 and the positive rate of ACS patients at different time of admission were analyzed and compared. The advantages and disadvantages of the three biochemical indexes of LP-PLA2, IMA, C Tn I and the significance of combined detection were discussed. The inflammatory response and oxidative stress were enhanced in.ACS patients, and the results were divided into LP-PLA2 and HS CRP, oxidative stress indicators and lipid biochemistry. The correlation of the index (high risk factors of ACS). Methods: from August 2015 to July 2016, a total of 153 cases of ACS patients were treated with coronary angiography, electrocardiogram, clinical symptoms and signs, which were hospitalized in emergency internal medicine and Department of Cardiology in No.1 Hospital of Jilin University and the clinical data were complete. The difference of hospital time was divided into group I (3 h) 57 cases, group II (3-6h) 42 cases and group III (6 h) 54 cases, and 50 cases of blood samples from physical examination center of No.1 Hospital of Jilin University were collected for the control group, and the serum LP-PLA2, IMA, C Tn I, HS CRP, CHO, TG, TG, dialectical and statistical analysis were carried out, and the results were statistically analyzed. Results: 1. The serum LP-PLA2, IMA, C Tn I and HS CRP were significantly higher than those of the control group (P0.05), TAS and SOD significantly lower than the control group (P0.05). Compared with the control group, the three indexes of P0.05.TAS, SOD and HS CRP were not statistically significant between the different experimental groups (P0.05), LP-PLA2, IMA, C Tn I three indexes were statistically significant (P0.05) among the different experimental groups (P0.05). P0.05.4.LP-PLA2 and TG (r=0.951, P0.01), CHO (r=0.961, P0.01), LDLC (r=0.902, P0.01) are positively related; Negative correlation. Conclusion: the concentration of 1.LP-PLA2 increased in the serum of ACS patients, and the specificity of.2.LP-PLA2 was significantly higher in the early stage than that of IMA, and its sensitivity was significantly better than that of C Tn I. The joint detection of IMA and C Tn I was better than that of IMA and C Tn I.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 費(fèi)菲;;最新解讀《脂蛋白相關(guān)磷脂酶A2臨床應(yīng)用中國(guó)專家建議》——第26屆長(zhǎng)城國(guó)際心臟病學(xué)會(huì)議(GW-ICC)暨亞太心臟大會(huì)201現(xiàn)場(chǎng)回顧[J];中國(guó)醫(yī)藥科學(xué);2015年21期

2 陳月梅;蔣洪敏;周志芳;;Cu~(2+)在缺血修飾性白蛋白形成中的作用探討[J];實(shí)用預(yù)防醫(yī)學(xué);2011年10期

3 陳作強(qiáng);趙仙先;秦永文;;血漿腦鈉肽在急性冠狀動(dòng)脈綜合征中的臨床應(yīng)用進(jìn)展[J];心血管病學(xué)進(jìn)展;2011年04期

4 鄔建民;張力;;脂蛋白相關(guān)磷脂酶A2在冠心病患者嚴(yán)重程度評(píng)估中的應(yīng)用[J];檢驗(yàn)醫(yī)學(xué);2011年02期

5 黃堯W，

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