| Objective: This study compared the diagnostic value of serum lipoprotein-related phospholipase A2(Lp-PLA2)and matrix metalloproteinase-9(MMP-9)in patients,and compared the diagnostic sensitivity and specificity of MMP-9 and carotid intima-media thickness(CIMT)combined with the results of carotid ultrasonography.Method: From December 2019 to November 2020,the Department of Cardiovascular Medicine,the First Affiliated Hospital of Hebei North University was selected to be diagnosed with the acute coronary syndrome,and coronary angiography was performed within 24 hours of hospitalization.The degree of coronary artery stenosis was ≥50% and further treatment was agreed upon.72 patients undergoing intravascular ultrasound examination were the experimental group.According to the results of intravascular ultrasound,they have divided into 38 cases in the vulnerable plaque group and 34 cases in the non-vulnerable plaque group.At the same time,33 patients with normal coronary angiography results were selected as the control group.Enzyme-linked immunosorbent assay was used to detect serum Lp-PLA2 and MMP-9 levels,to detect bilateral carotid artery ultrasound,and to measure CIMT and the number of carotid plaques.Gensini score was used to evaluate the degree of coronary artery stenosis,and intravascular ultrasound was used to evaluate the nature of the patient’s coronary plaque.The differences in levels of inflammatory factors and CIMT values among the three groups were compared,and the correlation between Pearson correlation analysis and Gensini score was used.A binary logistic regression analysis was performed to reveal the influencing factors of coronary artery vulnerable plaque.The ROC curve was used to analyze the diagnostic value of LP-PLA2,MMP-9,CIMT for coronary atherosclerotic plaque.Result:1.There is no statistical difference in age,gender,body mass index,blood lipids,creatine kinase,lactate dehydrogenase,history of hypertension,history of diabetes,history of smoking,etc.between vulnerable plaque group,non-vulnerable plaque group,and control group Academic significance(P>0.05).The differences in serum high-sensitivity C-reactive protein levels between the vulnerable plaque group,the non-vulnerable plaque group,and the control group were statistically significant(P<0.001),and the differences between the two groups were statistically significant(P<0.001).2.Serum Lp-PLA2 and MMP-9 levels in the vulnerable plaque group were significantly higher than those in the non-vulnerable plaque group,and the differences were statistically significant(P=0.004;P=0.041);The levels of serum Lp-PLA2 and MMP-9 in the vulnerable plaque group were significantly higher than those in the control group,and the difference was statistically significant(P<0.001);The levels of serum Lp-PLA2 and MMP-9 in the non-vulnerable plaque group were significantly higher than those in the control group,and the difference was statistically significant(P<0.001).3.CIMT: The CIMT value of the vulnerable plaque group was significantly higher than that of the non-vulnerable plaque group(P=0.027);The CIMT value of the vulnerable plaque group was significantly higher than that of the control group(P=0.003);Comparing the non-vulnerable plaque group and the control group,there was no significant difference in CIMT value(P=0.403).Carotid artery plaque detection rate: The detection rate of carotid artery plaque in the vulnerable plaque group was significantly higher than that in the non-vulnerable plaque group,and the difference was statistically significant(P=0.021);The detection rate of carotid artery plaque in the vulnerable plaque group was significantly higher than that in the control group,and the difference was statistically significant(P<0.001);There was no significant difference in the incidence of carotid plaque between the non-vulnerable plaque group and the control group(P=0.083).4.Serum Lp-PLA2 levels,serum MMP-9 levels,CIMT values were positively correlated with Gensini scores(r=0.781,0.805,0.360).5.The results of binary logistic regression analysis showed that LpPLA2,MMP-9,and CIMT were independent risk factors for vulnerable plaques.According to the ROC curve,the best diagnostic cut-off points of Lp-PLA2,MMP-9,and CIMT on vulnerable coronary plaques are309.49μg/L,54.17μg/L,0.927 mm,respectively,which predict the sensitivity of vulnerable plaques And specificity is Lp-PLA2(92.1%,67.2%);MMP-9(89.5%,67.2%);CIMT(84.2%,49.3%).When the three are combined,the sensitivity of predicting vulnerable plaque is 97.4%,and the specificity is74.6%.Conclusions:1.The levels of serum Lp-PLA2 and MMP-9 in patients with vulnerable coronary plaques are significantly increased,and the detection rate of CIMT and carotid plaques is significantly increased.2.Serum Lp-PLA2 level,serum MMP-9 level,CIMT and Gensini score are positively correlated,and the three can reflect the severity of coronary artery disease to a certain extent.3.Serum Lp-PLA2 levels,serum MMP-9 levels,and CIMT are independent risk factors for coronary vulnerable plaques.The combined detection of the three has high diagnostic value for coronary vulnerable plaques. |
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