Correlation Of Serum Lp-PLA2,CXCL16 And NLR Levels With Severity Of Coronary Artery Disease In Patients With Acute Coronary Syndrome

Objective: Aimed at the analysis of lipoprotein associated phospholipase A2(Lp-PLA2),chemokine ligand 16(CXCL16),neutrophil count and Neutrophil count to lymphocyte count ratio(NLR)associated with coronary lesion in acute coronary syndrome severity,vulnerable plaque.Methods: 1)the research object and grouping: From January 2016 to February 2017 admitted to Department of Cardiology in Affiliated Hospital of Zunyi Medical College underwent CAG examination diagnosed 224 cases of coronary heart disease patients,divided into acute coronary syndrome(ACS)group and stable angina pectoris(SAP)group,186 cases in ACS group(UA 75 cases,NSTEMI 52 cases,STEMI 59 cases),38 cases in group SAP.Patients examined by oct in ACS group were divided into plaque group(VP)and stable plaque group(SP),including 9 cases of VP group,8 cases in SP group;According to Gensini were divided into 57 cases of low level group,70 cases of middle level group,59 cases of high level group.2)the serum levels of Lp-PLA2 and CXCL16 were detected,All patients received arterial blood before CAG examination.The serum was stored at-80℃ low temperature refrigerator,and was determined by enzyme linked immunosorbent assay(ELISA).The Department of Clinical Laboratory of Zunyi Medical College helped to analyze serum neutrophil count and NLR levels.Results: 1)Compared with SAP group,UA group,NSTEMI group and STEMI group between the general information and blood biochemical indicator: Hypertension,Diabetes and Smoking are significant difference between the four groups(P < 0.05),TC,LDL,Lp-PLA2,CXCL16,Neutrophil count and NLR level in the presentation in the SAP group,UA group,NSTEMI group and STEMI group increased,and the difference was statistically significant(P < 0.05),while in the Age and Sex and Alcohol,there was no significant difference between the four groups(P > 0.05).2)Compared with SAP group,ACS group of patients with Hypertension,Smoking,Lp-PLA2,CXCL16,Neutrophil count and NLR levels were elevated,which the difference was statistically significant(P < 0.05).There was no significant difference in Age,Sex,Diabetes,Alcohol,TC and LDL(P > 0.05).The results of regression analysis showed that Hypertension and Lp-PLA2 are the risk factors of ACS.3)Compared with Stable plaque group,Vulnerable plaque group of patients with Hypertension,Smoking rate,LDL,Lp-PLA2,CXCL16,Neutrophil count and NLR levels were elevated,and the difference was statistically significant(P < 0.05),while there was no significant difference in Age,Sex,and Diabetes,TC and HDL(P > 0.05).4)According to the different Gensini integral level analysis: Age,Sex,Hypertension,Smoking,TC,Lp-PLA2,CXCL16,Neutrophil count and NLR in different Gensini groups showed statistical difference between groups(P < 0.05),while Diabetes,Alcohol,LDL and HDL showed no significant difference.Lp-PLA2,CXCL16,Neutrophil count,NLRwere positively correlated with high Gensini scores.Lp-PLA2,Neutrophil count,NLR had a good curve area under the prediction of high Gensini integral,while the area under CXCL16 curve was poor.Conclusion: The results of this study show that:1.Hypertension and Lp-PLA2 are the risk factors of ACS,and Lp-PLA2 is closely related to the vulnerability of plaques;2.CXCL16 and NLR are related to ACS and vulnerability of plaques;3.Lp-PLA2,Neutrophil count and NLR have certain predictive value for ACS coronary serious lesions;4.Lp-PLA2 is the best predictive of severe coronary lesions in ACS,When GS is higher than 5.95,the sensitivity and sensitivity of the patients are best.