Kocak Sedat, Ertekin Birsen, Girisgin Abdullah Sadik, Dundar Zerrin Defne, Ergin Mehmet, Mehmetoglu Idris, Bodur Said, Cander Basar
Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey.
Emergency Department, Beyhekim State Hospital, Konya, Turkey.
Turk J Emerg Med. 2016 Nov 20;17(2):56-60. doi: 10.1016/j.tjem.2016.10.001. eCollection 2017 Jun.
The study examined the Lp-PLA activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value.
The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups. The diagnostic value of Lp-PLA was determined based on receiver operating characteristic curves, sensitivity, specificity, predictive values, likelihood ratios and accuracy rates.
In all, 34 ACS and 32 AIS patients were included in the study, and the control group included 35 patients. Lp-PLA enzyme activity was significantly lower in the ACS and AIS groups than in the control group (26.7 ± 13.8, 31.4 ± 13.6, and 41.4 ± 8.1 nmol min·mL, respectively; p < 0.0001, p = 0.022). In the ACS group the area under the curve (AUC) was 0.825 (95%CI: 0.722-0.929), sensitivity was 71% for an optimal Lp-PLA cut-off value of 31.4 nmol min·mL, and specificity was 91%, whereas in the AIS group the AUC was 0.768 (95%CI: 0.652-0.884), sensitivity was 75% for an optimal Lp-PLA cut-off value of 38.1 nmol min·mL, and specificity was 74%.
Lp-PLA enzyme activity was significantly lower during the early stage of both ACS and AIS. The obtained statistic data suggest that low Lp-PLA enzyme activity can be used for diagnostic purposes.
本研究检测了因急性冠脉综合征（ACS）或急性缺血性卒中（AIS）就诊于急诊科的患者的脂蛋白相关磷脂酶A（Lp-PLA）活性及其诊断价值。
这项前瞻性研究纳入了2009年11月至2010年1月期间因ACS或AIS就诊于我院急诊科的年龄大于18岁的连续入选的男性和女性患者。在ACS组和AIS组确诊后立即采集血样。基于受试者工作特征曲线、敏感性、特异性、预测值、似然比和准确率来确定Lp-PLA的诊断价值。
本研究共纳入34例ACS患者和32例AIS患者，对照组包括35例患者。ACS组和AIS组的Lp-PLA酶活性显著低于对照组（分别为26.7±13.8、31.4±13.6和41.4±8.1nmol·min·mL；p<0.0001，p=0.022）。在ACS组，曲线下面积（AUC）为0.825（95%CI：0.722-0.929），当Lp-PLA最佳截断值为31.4nmol·min·mL时，敏感性为71%，特异性为91%；而在AIS组，AUC为0.768（95%CI：0.652-0.884），当Lp-PLA最佳截断值为38.1nmol·min·mL时，敏感性为75%，特异性为74%。
在ACS和AIS的早期阶段，Lp-PLA酶活性均显著降低。所获得的统计数据表明低Lp-PLA酶活性可用于诊断。
