冠心病合并心力衰竭患者Lp-PLA2、sST-2水平及与心功能、炎症因子的相关性分析

doi:10.3760/cma.j.cn441417-20250703-22012

摘要/Abstract

摘要： 目的　探析冠心病合并心力衰竭患者脂蛋白相关磷脂酶A2（Lp-PLA2）、可溶性生长刺激表达因子-2（sST-2）水平及与心功能、炎症因子的相关性。方法　选取2024年1月至2025年5月在启东市第二人民医院诊治的冠心病患者85例，其中41例合并心力衰竭。比较合并心力衰竭组、单纯冠心病组患者的一般资料、Lp-PLA2与sST-2水平、心功能指标［左心室射血分数（LVEF）、心输出量（CO）、左室缩末内径（LVESD）、左室舒末内径（LVEDD）］、炎症因子［中性粒细胞计数（NEUT）、降钙素原（PCT）、肝素结合蛋白（HBP）］。采用Pearson相关系数分析冠心病合并心力衰竭患者Lp-PLA2、sST-2水平及与心功能指标、炎症因子的相关性。采用t检验、χ²检验、Pearson相关性分析进行统计比较。结果　两组患者的一般资料比较，差异均无统计学意义（均P>0.05）。合并心力衰竭组患者Lp-PLA2、sST-2、NEUT、PCT、HBP水平高于单纯冠心病组，LVEF、CO小于单纯冠心病组，LVESD、LVEDD大于单纯冠心病组（均P<0.05）。Pearson相关性分析显示，合并心力衰竭组患者Lp-PLA2、sST-2水平与LVESD、LVEDD、NEUT、PCT、HBP呈正相关（r=0.708、0.594、0.401、0.412、0.328、0.732、0.610、0.419、0.448、0.357），与LVEF、CO呈负相关（r=-0.694、-0.525、-0.718、-0.573）。结论　冠心病合并心力衰竭患者的Lp-PLA2、sST-2表达进一步升高，且其水平与心功能、炎症因子之间存在相关性。

关键词: 冠心病, 心力衰竭, 脂蛋白相关磷脂酶A2, 可溶性生长刺激表达因子-2, 心功能, 炎症因子

Abstract:

Objective　To investigate the levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and soluble growth stimulating expression factor-2 (sST-2) and their correlation with cardiac function and inflammatory factors in patients with coronary heart disease and heart failure. Methods　A total of 85 patients with coronary heart disease (including 41 patients with heart failure) diagnosed and treated in Qidong Second People's Hospital from January 2024 to May 2025 were selected as the study objects. The general data, levels of Lp-PLA2 and sST-2, cardiac function indicators [left ventricular ejection fraction (LVEF), cardiac output (CO), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD)], and inflammatory factors [neutrophil count (NEUT), procalcitonin (PCT), and heparin-binding protein (HBP)] were compared between the patients complicated with heart failure and the patients with only coronary heart disease. The Pearson correlation coefficient was used to analyze the levels of Lp-PLA2 and sST-2 in the patients with coronary heart disease and heart failure, as well as their correlation with cardiac function and inflammatory factors. Statistics were performed using t-test, χ² test, and Pearson correlation analysis. Results　There were no statistical differences in the general data between the two groups (all P>0.05). The levels of Lp-PLA2, sST-2, NEUT, PCT, and HBP, LVESD, and LVEDD in the heart failure group were higher than those in the simple coronary heart disease group, and the LVEF and CO were lower (all P<0.05). The NEUT, PCT and HBP in the heart failure group were significantly higher than those in the simple coronary heart disease group (all P<0.05). The Pearson correlation analysis showed that the levels of Lp-PLA2 and sST-2 were positively correlated with LVESD, LVEDD, NEUT, PCT, and HBP (r=0.708, 0.594, 0.401, 0.412, 0.328, 0.732, 0.610, 0.419, 0.448, and 0.357), and negatively with LVEF and CO (r=-0.694, -0.525, -0.718, and -0.573) in the patients with heart failure. Conclusion　The expression of Lp-PLA2 and sST-2 in patients with coronary heart disease and heart failure is further increased, and their levels are correlated with cardiac function and inflammatory factors.

Key words: Coronary heart disease, Heart failure, Lipoprotein-associated phospholipase A2, Soluble growth stimulating expression factor-2, , Cardiac function, Inflammatory factors

杨燕驰. 冠心病合并心力衰竭患者Lp-PLA2、sST-2水平及与心功能、炎症因子的相关性分析[J]. 国际医药卫生导报, 2025, 31(22): 3761-3765.

Yang Yanchi. Levels of Lp-PLA2 and sST-2 and their correlation with cardiac function and inflammatory factors in patients with coronary heart disease and heart failure[J]. International Medicine and Health Guidance News, 2025, 31(22): 3761-3765.

参考文献

[1] «冠状动脉粥样硬化性心脏病患者药物治疗管理路径专家共识»编写组. 冠状动脉粥样硬化性心脏病患者药物治疗管理路径专家共识[J]. 临床药物治疗杂志,2023,21(6):1-18. DOI:10.3969/j.issn.1672-3384.2023.06.001.
[2] 莘琳琳,李禹龙,袁慧. 心力衰竭相关标志物研究进展[J]. 医学研究杂志,2021,50(2):5-8. DOI:10.11969/j.issn.1673-548X.2021.02.002.
[3] 姚德莉,蒲丽君. 新型生物标志物检测在老年慢性心力衰竭中的应用进展[J]. 老年医学与保健,2025,31(1):281-284.DOI: 10.3969/j.issn.1008-8296.2025.01.058.
[4] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等. 稳定性冠心病基层诊疗指南(2020年)[J]. 中华全科医师杂志,2021,20(3):265-273. DOI:10.3760/cma.j.cn114798-20210120-00079.
[5] 方杰. 冠心病危险因素聚集的研究进展[J]. 护理研究,2023,37(23):4241-4246. DOI:10.12102/j.issn.1009-6493.2023.23.013.
[6] 陈芳.老年冠心病冠脉病变临床特征及相关危险因素分析[J].解放军预防医学杂志,2020,38(9):104-106.DOI:10.13704/j.cnki.jyyx.2020.09.034.
[7] 陈蓉,于子翔,马依彤. 冠心病合并射血分数保留型心力衰竭的研究进展[J]. 中国心血管病研究,2022,20(9):850-853. DOI: 10.3969/j.issn.1672-5301.2022.09.013.
[8] 刘秀敏,梁秋花. 慢性心力衰竭患者实验室指标与心功能水平相关性研究[J]. 血栓与止血学,2021,27(6):943-944. DOI: 10.3969/j.issn.1009-6213.2021.06.016.
[9] 陈在旺. 生化指标联合检测在心力衰竭患者诊断过程中的应用效果[J]. 中国保健营养,2021,31(12):263.
[10] Yu B , Shi G D , Yang F ,et al. Correlation of LP-PLA2 and MMP-9 with the occurrence of early neurological deterioration in patients with acute ischemic stroke[J].Medicine, 2024,103(21):5.DOI:10.1097/MD.0000000000038310.
[11] 刘杰,潘伟彪. 脂蛋白相关磷脂酶A2在冠心病及其病变程度中的研究进展[J]. 国际医药卫生导报,2020,26(22):3541-3545. DOI:10.3760/cma.j.issn.1007-1245.2020.22.054.
[12] 王平平,张鑫,逢国娟. PAPP-A,Lp-PLA2,FGF23在冠心病患者中的表达与诱发的危险因素分析[J].中国循证心血管医学杂志,2023,15(5):619-621. DOI: 10.3969/j.issn.1674-4055.2023.05.24.
[13] 乌云嘎,魏君,常宏,等. LP-PLA2:预测心血管疾病的新兴标志物[J]. 中国实验诊断学,2022,26(9):1417-1419. DOI: 10.3969/j.issn.1007-4287.2022.09.041.
[14] 张佳佳王缚鲲.Lp-PLA2基因多态性在心血管疾病中的功能分析[J].心血管病学进展,2024,45(4):359-363.DOI: 10.16806/j.cnki.issn.1004-3934.2024.04.016.
[15] 何春琳,刘朏,杜洪洋,等.外周血Lp-PLA2,LP(a)及hs-CRP与老年冠心病及其严重程度的关联性研究[J].中国循证心血管医学杂志,2024,16(11):1366-1368. DOI: 10.3969/j.issn.1674-4055.2024.11.21.
[16] 宋颖懿.脂蛋白相关磷脂酶A2、同型半胱氨酸与慢性心力衰竭患者预后的相关性分析[D].青岛:青岛大学,2019.DOI:10.27262/d.cnki.gqdau.2019.000009.
[17] Hildenbrand FF, Illi B, Felten SV, et al.Evaluation of soluble suppression of tumorigenicity 2 (sST2) as serum marker for liver fibrosis[J].BMC Gastroenterology, 2024,24(1):11.DOI:10.1186/s12876-023-03116-4.
[18] van den Berg VJ, Vroegindewey MM, Umans VA,et al. Persistently elevated levels of sST2 after acute coronary syndrome are associated with recurrent cardiac events[J]. Biomarkers,2022,27(3):264-269.DOI: 10.1080/1354750X.2022.2032350.
[19] 位晓珍,姬晓玲,夏松磊.血清sST2、BNP、CA125与慢性心力衰竭患者心功能及短期预后的相关性研究[J].牡丹江医学院学报,2024,45(1):43-46,29.DOI:10.13799/j.cnki.mdjyxyxb.2024.01.007.
[20] 万文清.可溶性生长刺激表达因子-2和左心室质量指数对慢性心力衰竭的诊断价值及二者的相关性研究[D].合肥:安徽医科大学,2024.DOI:10.26921/d.cnki.ganyu.2024.001395.
[21] 任四鹏.可溶性肿瘤生成抑制因子2(sST2)与冠心病合并心力衰竭预后关系的相关研究[D].长春:吉林大学,2024.DOI:10.27162/d.cnki.gjlin.2024.002081.
[22] 何璐,李慧,李玲玲,等. 血清sST-2、hs-CRP、NT-proBNP、IGF-1与慢性心力衰竭严重程度的关系研究[J].中国现代医学杂志,2025,35(9):13-20.DOI: 10.3969/j.issn.1005-8982.2025.09.003.
[23] 刘昭君.系统性炎症指标在心力衰竭临床评估中的作用及预测模型构建[D].重庆:重庆医科大学,2022.DOI:10.27674/d.cnki.gcyku.2022.000580.
[24] 许坦.冠心病患者心率变异性及Hcy、炎症因子水平变化与冠脉病变程度和预后的关系[D].合肥:安徽医科大学,2024.DOI:10.26921/d.cnki.ganyu.2024.001941.
[25] 段佳佳,夏大胜.慢性心力衰竭患者炎性细胞因子的变化及作用[J].中国心血管杂志, 2012,17(2):93-95.DOI:10.3969/j.issn.1007-5410.2012.02.005.