表观健康人群血清脂蛋白相关磷脂酶A2参考区间的建立

摘要

目的 建立上海地区表观健康人群血清脂蛋白相关磷脂酶A2(Lp-PLA2)的参考区间.方法 检测800名健康体检者(男、女性各400名)血清Lp-PLA2活性,根据美国临床实验室标准化协会(CLSI)C28-A3文件的相关要求,以百分位数法确定Lp-PLA2的95%参考区间[第2.5百分位数(P2.5)~第97.5百分位数(P97.5),可信区间为90%].结果 表观健康人群血清Lp-PLA2活性呈正态分布.男性Lp-PLA2活性为(479±126)U/L,女性为(433±118)U/L,二者间差异有统计学意义(t=5.311,P<0.01).男性血清Lp-PLA2活性保持恒定,女性血清Lp-PLA2活性随年龄的增加而呈升高趋势,各年龄段Lp-PLA2活性比较差异有统计学意义(F=2.017,P<0.05).进一步分析显示<50岁的各年龄组之间和≥50岁的各年龄组之间Lp-PLA2活性差异均无统计学意义(P>0.05),因此将女性各年龄组合并为18~49岁组和50~89岁组.由此得出上海地区表观健康人群血清Lp-PLA2的参考区间男性为219~694 U/L,女性18~49岁为204~651 U/L、50~89岁为217~686 U/L.结论 初步建立了上海地区表观健康人群血清Lp-PLA2的参考区间,为临床应用Lp-PLA2作为心血管疾病风险评估指标提供依据.%Objective To establish the reference intervals of serum lipoprotein-associated phospholipase A2 (Lp-PLA2)in apparently healthy adults.Methods The activities of serum Lp-PLA2 in 800 apparently healthy adults(400 males and 400 females) were determined,and the 95% reference intervals [the 2.5th percentile (P2.5)-the 97.5th percentile(P97.5),90% confidence interval] were determined,according to the Clinical and Laboratory Standards Institute(CLSI)C28-A3.Results Serum Lp-PLA2 activities showed a normal distribution in apparently healthy adults. The reference intervals of serum Lp-PLA2 activities were(479±126) U/L in males and (433±118) U/L in females with statistical significance(t=5.311,P<0.01). Serum Lp-PLA2 activities were stable in males,while those in females increased with age,and there was statistical significance for age(F=2.017, P<0.05). There was no statistical significance for serum Lp-PLA2 activities in females between <50 years old and ≥50 years old(P>0.05),and thus females could be classified into 18-49 years old group and 50-89 years old group. Therefore,the reference intervals of serum Lp-PLA2 activities in apparently healthy adults were 219-694 U/L for males,204-651 U/L for 18-49 years old females and 217-686 U/L for 50-89 years old females.Conclusions The reference intervals of serum Lp-PLA2 activities in apparently healthy adults have been established initially,which provide a reference for the clinical application of serum Lp-PLA2 as an indicator for the assessment of cardiovascular risk.