| BackgroundCoronary atherosclerotic heart disease(coronary atherosclerotic heart diseases)or coronary heart disease(coronary heart diseases,CHD),It is one of the most important cardiovascular diseases threatening human health in the world today.The clinical manifestations of this disease vary in severity,so early accurate assessment of CHD severity and cardiovascular risk,as well as the choice of individualized treatment plan,are of great significance to the prognosis of patients.Over the past two decades,coronary atherosclerosis is defined as a dynamic process of chronic inflammation,RDW and Lp-PLA2 as biomarkers associated with inflammation,a growing number of studies have shown that they are closely related with theformation,progression of atherosclerosis plaqus cardiovascular events,It has predictive value for CHD.Although both indicators have been studied in the laboratory diagnosis of CHD,single indicators are not ideal for predicting CHD and assessing the degree of coronary artery disease.RDW and Lp-PLA2 are consistent in the diagnosis of CHD patients,so the purpose of this study is to analyze the relationship between the two indicators and the severity of CHD disease,and to explore the value of the combination of RDW and Lp-PLA2 in the diagnosis of CHD experiment.ObjectiveTo analyze the relationship between RDW,Lp-PLA2 and the severity of CHD disease,and to explore the value of combined detection of two simple and easily available indicators in CHD experimental diagnosis.MethodsThis study retrospectively analyzed the clinical data of 228 patients admitted to a third class hospital from January 2018 to September 2019 for chest pain and tightness and coronary angiography(CAG),all of whom were untreated within 24 hours from onset to admission.According to CAG results,patients were divided into CHD group(CHD,n=159)and control group(n=63).Patients in the CHD group were divided into single-vessel disease group(n=32)double-vessel disease group(n=61)three-vessel disease group(n=66)according to the number of coronary artery lesions.The results of RDW?Lp-PLA2 and other parameters were collected 24 hours after admission,and the relationship between the study indicators and the severity of CHD was statistically analyzed.At the same time,receiver operating characteristic curve(ROC curve)was used to calculate the optimal critical value of CHD for screening prediction,and the authenticity and reliability performance of target parameters was evaluated according to the evaluation method of screening test.Results1.Comparison of general clinical data between the CHD group and the control groupThere was no statistically significant difference in gender,age,hypertension and other indicators between the CHD group and the control group(P>0.05),while the smoking rate was significantly higher than that of the control group.The levels of PDW,TC,TG,LDL,RDW,Lp-PLA2 were all higher than that of the control group,while the levels of HDL were lower than that of the control group,and the differences were statistically significant(P<0.05).2.CHD risk factor analysisMultivariate Logstic regression analysis using coronary heart disease as the dependent variable and indicators with statistically significant differences between the CHD group and the control group as the independent variables concluded that LDL,RDW,Lp-PLA2 was a risk factor for CHD.3.The correlation analysis with RDW,Lp-PLA2 and Gensini scoreThe two indexes were positively correlated with the Gensini integral,and the correlation coefficients were 0.706,0.690(P<0.01).4.Changes of RDW,Lp-PLA2 in control group and CHD groupRDW,Lp-PLA2 gradually increased in the double-branch disease group of the single-branch disease group,and the difference between each lesion group was statistically significant(P<0.05).5.ROC curve analysis of three indexes to predict CHDAccording to ROC curve,the cut off values of RDW,Lp-PLA2,LDL for predicted CHD were 12.35%,133.975ng/mL,2.585mmol/L,RDW,Lp-PLA2,LDL,RDW combined with Lp-PLA2,LDL combined with RDW,RDW combined with Lp-PLA2 area under curve(AUC)was 0.832,0.833,0.689,0.846,0.867,0.893,the sensitivity was 75.5%,73.0%,62.9%,88.1%,90.6%,92.4%,the specificity was 79.4%,84.1%,66.7%,52.4,55.6,68.3%,the positive likelihood ratio was 3.67,4.59,1.89,1.85,2.04,2.91,and the negative likelihood ratio was 0.31,0.32,0.56,0.23,0.17,0.11.ConclusionRDW,Lp-PLA2 is closely related to the severity of CHD disease,the more severe the disease,the higher the level of both indicators.The combined detection of two indicators can be used as a simple and effective indicator for early CHD prediction. |
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