Correlation Between Lipoprotein Associated Phospholipaselipoprotein (a) And Coronary Heart Disease

Objective:in order to investigate the significance of lioprotein phospholipase A2and lipoprotein（a）in the diagnosis of coronary heart disease and its correlation with the severity of coronary artery disease.Methods:a retrospective case analysis,the selection in July 2018 to January 2019in shaanxi province people’s hospital of cardiology,161 cases of patients with coronary heart disease（CHD）,examination of all patients who suffer coronary artery angiography examination,by the deputy director of the physician and above coronary angiography results are given,then according to the results of coronary angiography,161 patients were divided into 40 cases of normal group（control group）and 121 cases of coronary heart disease group.According to the number of coronary artery lesions involved,the CHD group was further divided into the single-vessel lesion group（48 cases）,the double-vessel lesion group（37 cases）and the multi-vessel lesion group（36 cases）.Finally,according to the Gensini integral method,patients in the CHD group were divided into34 patients in the low-risk group（Gensini integral 1-30 points）,63 patients in the medium-risk group（Gensini integral 31-90 points）,and 24 patients in the high-risk group（Gensini integral 91 points）.Collect all of the patients cereal third transaminase（ALT）,aspertate aminotransferase（AST）,total cholesterol（TC）,triglyceride（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,apolipoprotein（apo-A）,apolipoprotein B（apo B）,lipoprotein（A）,fibrinogen（Fib）,blood uric acid（URC）,blood urea nitrogen（BUN）,serum creatinine（SCR）,lipoprotein phospholipase A2（LP-PLA2）and relevant biochemical index,and smoking history,history of diabetes.To analyze whether there were differences in general biochemical indexes between the CHD group and the normal group,between groups with different indexes of coronary artery disease,and between groups with different degrees of risk,and to compare the differences in lipoprotein（a）and lipoprotein related phospholipase A2 among different groups,and to analyze the correlation between them and the degree of coronary artery stenosis and the degree of Gensini integral risk.All data were processed by t test,chi-square test,spearman correlation coefficient analysis,multiple linear regression analysis,ROC curve analysis and other statistical methods of independent samples,P<0.05 was considered statistically significant.Results:1.Serum lipoprotein（a）levels were significantly higher in the single-vessel disease group（168.37mg/L±71.14mg/L）,the double-vessel disease group（210.11mg/L±116.15mg/L）and the multi-vessel disease group（303.99mg/L±74.75mg/L）than the normal group（82.70mg/L±31.37mg/L）,with statistically significant differences（P<0.01）,and the difference was also statistically significant in the multi-vessel lesion group with double-vessel>lesion and single-vessel>lesion（P<0.01）;In the high-risk group（352.41mg/L±113.82mg/L）,the medium-risk group（214.85mg/L±74.57mg/L）,the low-risk group（141.38mg/L±29.79mg/L）,and the high-risk group>medium-risk group>low-risk group,the differences were statistically significant（P<0.01）.Serum lipoprotein-associated phospholipase A2 levels in the multi-vessel disease group（245.84ng/ml±63.88ng/ml）,the double-vessel disease group（180.38ng/ml±39.28ng/ml）and the single-vessel disease group（156.63ng/ml±33.66ng/ml）were higher than those in the control group（100.42ng/ml±28.77ng/ml）,and the differences were statistically significant（P<0）.01),and the difference was also statistically significant in the multi-vessel lesion group and the double-vessel lesion group and the single-vessel lesion group（P<0）.01);The high-risk group（228.34ng/ml±7.87ng/ml）,the medium-risk group（178.03ng/ml±30.25ng/ml）,and the low-risk group（137.41ng/ml±23.72ng/ml）had statistically significant differences（P<0.01）.2.There were no statistically significant differences in the levels of alanine tr ansaminase,creatinine,urea nitrogen,uric acid and fibrinogen between the CHD g roup and the control group（P>0.05）.Coronary heart disease group aspertate aminot ransferase,total cholesterol,triglyceride,low density lipoprotein,apolipoprotein AI,apolipoprotein B compared with control group,compare the differences between groups were statistically significant（P<0.05）,aspertate aminotransferase,total ch olesterol,triglyceride,apolipoprotein B,low density lipoprotein cholesterol in CHD group is higher than normal control group,and high-density lipoprotein cholester ol and apolipoprotein AI in CHD group is lower than normal control group.3.Serum lipoprotein（a）and serum lipoprotein related phospholipase A2 level s were positively correlated with the occurrence of coronary heart disease,and the correlation coefficients of the two were r（serum lipoprotein（a））=0.633 and r2（serum lipoprotein related phospholipase A2）=0.673（P<0.01）,respectively Seru m lipoprotein（a）and serum lipoprotein related phospholipase A2 levels were posi tively correlated with the severity of Gensini integral.The regression equation was Y=0.333X₁+0.172 X₂-252.807(Y:Gensini integral;X₁:lipoprotein phospholipase A2;X₂:lipoprotein（a）,regression equation F=72.27,P<0.001,regression equation was statistically significant.4.The area under the ROC curve of lipoprotein related phospholipase A2 for the diagnosis accuracy of coronary heart disease was 0.936,and the area under the ROC curve of lipoprotein（a）for the diagnosis accuracy of coronary heart disease was 0.971,both of which were higher than LDL-C（area under the ROC curve=0.684）and apolipoprotein A（area under the ROC curve=0.761）,both of which had high sensitivity and specificity for the diagnosis of coronary heart disease.Conclusions:1.Lp（a）and lp-pla2 levels are positively correlated with the occurrence of coronary heart disease,and are independent risk factors for predicti ng coronary heart disease.With the increase of the number of lesions or the incr ease of Gensini integral,the serum concentrations of both will increase accordingl y.Both of them have high sensitivity and specificity for the prediction of coronary heart disease.Combined examination of the two can improve the accuracy of the prediction of coronary heart disease,so as to improve the identification of coron ary heart disease,early diagnosis and early treatment,and avoid the delay of the aggravation of the disease.3.The levels of triglycerides,total cholesterol,apolipoprotein B and LDL ch olesterol in the CHD group were higher than those in the normal control group,while the levels of HDL cholesterol and apolipoprotein AI were exactly the oppos ite.