摘要
目的 探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)、血尿酸(UA)在老年高血压患者10年心血管疾病危险度分层中的作用。方法 选取2020年3月—2022年3月某医院收治的459例老年高血压患者,根据患者10年心血管疾病危险度分为低危组(n=135)、中危组(n=194)、高危组(n=130),应用Spearman分析、多元线性回归分析血清Lp-PLA2、UA与10年心血管疾病危险度关系,使用交互作用系数γ和OR危险度分析血清Lp-PLA2、UA的交互作用及类型。结果 低危组、中危组、高危组血清Lp-PLA2分别为(206.87±34.29)、(248.55±31.04)、(290.36±35.67)μg/L,血清UA分别为(429.17±48.69)、(480.55±53.2)、(480.55±53.2)μmol/L,血清Lp-PLA2、UA均随危险度升高依次升高,两两比较差异均有统计学意义(Lp-PLA2:t=11.146、20.364、11.056;UA:t=9.329、18.672、11.018,P值均<0.05);血清Lp-PLA2(r=0.710)、UA(r=0.728)均与10年心血管疾病危险度呈正相关(P值均<0.05);校正吸烟史、收缩压、舒张压、高密度脂蛋白、空腹血糖、糖化血红蛋白等因素后,血清Lp-PLA2、UA仍与Framingham危险评分显著相关(P值均<0.05)。交互作用分析结果显示,Lp-PLA2对UA的效应具有正向交互作用,两者交互作用为次相乘模型。结论 血清Lp-PLA2、UA联合检测可作为危险度分层及预测患者10年心血管疾病危险度的标志物,为临床防治心血管疾病提供参考。
Objective To investigate the role of serum lipoprotein-associated phospholipase A2(Lp-PLA2) and uric acid(UA) in stratification of the 10-year risk for cardiovascular diseases among elderly hypertensive patients. Methods A total of 459 elderly hypertensive patients admitted to a hospital during the period from Mar 2020 to Mar 2022 were recruited and assigned into the low-(n=135),moderate-(n=194),and high-risk group(n=130) according to the 10-year risk for cardiovascular diseases. The associations of serum Lp-PLA2 and UA with the 10-year risk for cardiovascular diseases were evaluated using Spearman and multivariate linear regression analyses, and the interactions between serum Lp-PLA2 and UA were examined with interaction coefficient γ and odds ratio(OR). Results The serum Lp-PLA2 and UA levels were(206.87±34.29) μg/L and(429.17±48.69) μmol/L in the low-risk group,(248.55±31.04) μg/L and(480.55±53.2) μmol/L in the moderate-risk group and(290.36±35.67)μg/L and(480.55±53.2) μmol/L in the high-risk group, and both Lp-PLA2 and UA levels increased with the 10-year risk for cardiovascular diseases(Lp-PLA2: t=11.146,20.364 and 11.056;UA: t=9.329,18.672 and 11.018;all P<0.05). The serum Lp-PLA2(r=0.710,P <0.05) and UA levels(r=0.728,P <0.05) positively correlated with the 10-year risk for cardiovascular diseases, and after adjustment for history of smoking, systolic blood pressure, diastolic blood pressure, high-density lipoprotein, fasting blood glucose and glycated haemoglobin, serum Lp-PLA2 and UA levels still correlated significantly with the Framingham risk score(all P<0.05).In addition, there was a positive interaction between serum Lp-PLA2 and UA,with a submultiplicative function between them. Conclusion The combination of serum Lp-PLA2 and UA may serve as a marker for risk stratification and prediction of 10-year risk for cardiovascular diseases among elderly hypertensive patients, which provides insights into the clinical management of cardiovascular diseases.
作者
赵小建
刘凯
孟凡森
孙小淋
刘敏
ZHAO Xiao-jian;LIU Kai;MENG Fan-sen;SUN Xiao-lin;LIU Min(Henan Provincial People's Hospital,People's Hospital of Zhengzhou University,Henan Zhengzhou 450003,China)
出处
《江苏预防医学》
CAS
2022年第6期632-635,639,共5页
Jiangsu Journal of Preventive Medicine
基金
河南省自然科学基金(202300410454)。
关键词
血清脂蛋白相关磷脂酶A2
血尿酸
老年人
高血压
10年心血管疾病危险度
Serum lipoprotein-associated phospholipase A2
Serum uric acid
Elderly
Hypertension
10-year risk for cardiovascular disease
