第34卷第3期长治医学院学报VoL34No.32222020年6月JOURNALOFCHANGZH1MED1CAICOLLEGEJun.2020p2■微球蛋白、糖化血红蛋白、脂蛋白相关磷脂酶A2和磷酸葡萄糖变位酶联合检测在冠心病诊断中的价值蒋淑娟摘要目的：探讨■微球蛋白(02M)、糖化血红蛋白(HbAlc)、脂蛋白相关磷脂酶A2(Lp-PLA2)N磷酸葡萄糖变位酶(PGM)联合检测诊断冠心病(CHD)的价值。方法：选择135例CHD患者为CHD组，另选择本院同期健康体检者70例作为对照组，收集血液样本，放射免疫法检测J32M,免疫比浊法检测HbAlc,酶联免疫吸附法检测Lp-PLA2、PGM,采用Logistics回归分析CHD发生的相关因素，采用ROC分析诊断试验的灵敏度和特异度。结果：CHD组血清°2M、HbAlc、Lp.PLA2、PGM水平均显著高于对照组(P<0.05)；Logistics回归分析显示，高水平［32M、HbAlc、Lp-PLA2、PGM是发生CHD的危险因素；R2M(临界值2.65牌・mLT)、HbAlc(临界值5.00%)、Lp-PLA2(临界值197.20ng-mL-')、PGM(临界值34.52U-L")联合检测诊断CHD的AUC为0.949,准确度为95.12%,灵敏度为95.56%,特异度为94.29%,均明显高于单项检测。结论：CHD患者02M、HbAlc、Lp.PLA2、PGM水平显著升高，联合检测诊断CHD的准确度和灵敏度更高。关键词禺■微球蛋白；糖化血红蛋白；脂蛋白相关磷脂酶A2；磷酸葡萄糖变位酶；冠心病中图分类号R541.4文献标识码A文章编号1006(2020)03-222-05Valveofcombineddefectionofp2M,HbAlc,Lp-PLA2andPGMintheDiagnosisofCHDJiangShujuanZhengzhouFirstPeople'sHospitalAbstractObjective:Toexploretheaccuracyandsensitivityofcombineddetectionofp2-microglobulin(p2M),glycosylatedhemoglobin(HbAlc),lipoprotein-associatedphospholipaseA2(Lp-PLA2)andphosphoglucomutase(PGM)inthediagnosisofcoronaryheartdisease(CHD).Methods:135CHDpatientsadmittedasCHDgroupwhile70healthyexaminersinthehospitalinthesameperiodwereselectedasthecontrolgroup.Thebloodsampleswerecollected,and^2Mwasdetectedbyradioimmuno-assay,andHbAlcwasdetectedbyimmunoturbidimetry,andLp-PLA2andPGMweredetectedbyenzyme-linkedimmunosorbentassay9andlogisticsregressionanalysiswasperformedontherelatedfactorsaffectingtheoccurrenceofCHD.ThesensitivityandspecificityofdiagnostictestswereanalyzedusingROCanalysis.Results:Theserumlevelsofp2M,HbAlc,Lp-PLA2andPGMinCHDgroupweresignificantlyhigherthanthoseincontrolgroup(P<0.05).Logisticsregressionanalysisshowedthathighlevelsofp2M,HbAlc,Lp-PLA2andPGMwereriskfactorsforCHDoccurrence.TheAUC,accuracy,sensitivityandspecificityofcombineddetectionofcriticalvalue02M(criticalvalueof2.65瞄・mL"1),HbAlc(criticalvalueof5.00%),Lp-PLA2(criticalvalueof197.20ng・mL-1)andPGM(criticalvalueof34.52U・L"1)were0.949,95.12%,95.56%and94.29%inthediagnosisofCHD,whichweresignificantlyhigherthanthoseofsingledetection.Conclusion:Thelevelsofp2M,HbAlc,Lp-PLA2andPCMinCHDpatientsaresignificandyincreased.CombineddetectionhashigheraccuracyandsensitivityinthediagnosisofCHD.Keywordsp2-microglobulin；glycatedhemoglobin；lipoprolein-associatedphospholipaseA2；phosphoglucomutase;coronaryheartdisease冠心病(coronaryheartdisease,CHD)是指冠状肌缺血、缺氧或坏死而引发的心脏病，严重威胁人动脉发生粥样硬化引起血管狭窄或闭塞，导致心类健康口"CHD好发于40岁以上人群，我国CHD发病率虽低于欧洲和北美国家，但近年其发病率作者单位郑州市第一人民医院(450000)作者单位郑州市第一人民医院(450000)呈上升趋势，每年心脏病治疗耗费300多亿，给社会和家庭造成严重的经济负担、劳力负担⑵。相关研究表明，高龄、高血压、吸烟、血脂异常等是CHD发生的危险因素，一些新的危险因素如&■微球蛋白（p2-microglobulin,p2M）、糖化血红蛋白（glycosylatedhemoglobin,HbAlc）、脂蛋白相关磷月旨酶A2（lipoproteinrelatedphospholipaseA2,Lp-PLA2）、磷酸葡萄糖变位酶（phosphoglucomu...