临床医学

Lp(a)、CHR对急性心肌梗死患者短期预后的预测价值分析*

  • 包瑞娜 ,
  • 汪英男 ,
  • 赵瑞平
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  • 1.内蒙古科技大学包头医学院,内蒙古包头 014040;
    2.乌兰察布市中心医院老年病学科;
    3.包头市中心医院心内科,内蒙古包头 014040
汪英男, 赵瑞平

收稿日期: 2023-06-02

  网络出版日期: 2024-04-19

基金资助

*乌兰察布市科技计划项目(2020.12.01)

The predictive value of Lp(a) and CHR for short-term prognosis in patients with acute myocardial infarction

  • BAO Ruina ,
  • WANG Yingnan ,
  • ZHAO Ruiping
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  • 1. Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou 014040;
    2. Department of Geriatric, Ulanqab Central Hospital;
    3. Department of Cardiology, Baotou Central Hospital, Baotou 014040

Received date: 2023-06-02

  Online published: 2024-04-19

摘要

目的: 探讨血清脂蛋白(a)[Lp(a)]、超敏C反应蛋白/高密度脂蛋白比值(CHR)对急性心肌梗死(AMI)患者短期预后的预测价值。方法: 选取2021年7月至2022年7月于包头市中心医院心内科就诊并行经皮冠状动脉介入治疗的251例AMI患者进行回顾性分析。采集入组患者的一般资料、实验室指标、killip分级、射血分数(EF值)及冠脉造影结果,根据实验室指标和冠脉造影结果分别计算出CHR值和Gensini评分。按照AMI患者住院期间是否发生主要不良心血管事件(MACE)分为观察组和对照组,比较两组患者的一般资料及实验室指标差异。采取单因素和多因素Logistic回归分析AMI患者住院期间发生MACE的影响因素。运用受试者工作特征曲线(ROC)分析Lp(a)、CHR及Lp(a)联合检测CHR对发生MACE的预测价值。结果: 观察组患者Lp(a)、CHR、killip分级≥Ⅱ级者占比、Gensini评分均高于对照组,差异有统计学意义(P<0.05)。Lp(a)、CHR是AMI患者住院期间发生MACE的独立危险因素。ROC曲线表明,Lp(a)、CHR和Lp(a)联合检测CHR对AMI患者住院期间发生MACE有预测价值,联合检测价值更高 。结论: Lp(a)、CHR是AMI患者住院期间发生MACE的独立危险因素,Lp(a)联合检测CHR有利于评估AMI患者的短期预后。

本文引用格式

包瑞娜 , 汪英男 , 赵瑞平 . Lp(a)、CHR对急性心肌梗死患者短期预后的预测价值分析*[J]. 包头医学院学报, 2024 , 40(4) : 42 -46 . DOI: 10.16833/j.cnki.jbmc.2024.04.008

Abstract

Objective: To investigate the predictive value of serum lipoprotein (a) [Lp(a)] and high-sensitivity C-reactive protein/high-density lipoprotein ratio (CHR) for short-term prognosis in patients with acute myocardial infarction (AMI). Methods: A total of 251 patients with AMI who underwent percutaneous coronary intervention in the Department of Cardiology of Baotou Central Hospital from July 2021 to July 2022 were selected for retrospective analysis. The general data, laboratory indexes, killip classification, ejection fraction (EF value) and coronary angiography results of the enrolled patients were collected. The CHR value and Gensini score were calculated according to the laboratory indexes and coronary angiography results. According to whether major adverse cardiovascular events (MACE) occurred during hospitalization of AMI patients, they were divided into observation group and control group. The differences of general data and laboratory indexes between the two groups were compared. Univariate and multivariate logistic regression were used to analyze the influencing factors of MACE in AMI patients during hospitalization. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of Lp(a), CHR and Lp(a) combined detection of CHR for MACE. Results: The Lp(a), CHR, killip grade≥II and Gensini score in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05). Lp (a) and CHR were independent risk factors for MACE in patients with AMI during hospitalization. ROC curve showed that the combined detection of Lp(a), CHR and Lp(a) CHR had predictive value for MACE in AMI patients during hospitalization, and the combined detection value was higher. Conclusion: Lp(a) and CHR are independent risk factors for MACE in AMI patients during hospitalization. Combined detection of Lp(a) and CHR is helpful to evaluate the short-term prognosis of AMI patients.

参考文献

[1] The Writing Committee of the Report on Cardiovascular Health Diseases in China.《中国心血管健康与疾病报告2021》要点解读[J].中国心血管杂志,2022,27(4):305-318.
[2] Reed GW, Rossi JE, Cannon CP. Acute myocardial infarction[J].Lancet,2017,389(10065):197-210.
[3] 廖付军,鲍海龙,谢登海,等. 冠心病患者胆红素血脂综合指数与冠状动脉狭窄程度的相关性[J].贵州医科大学学报,2021,46(8): 925-930.
[4] Whayne TF.Non-traditional cardiovascular risk markers in the era of established major risk factors and multiple guidelines[J].Curr Vasc Pharmacol,2019,17(3):270-277.
[5] Wilson DP,Jacobson TA,Jones PH,et al. Use of Lipoprotein(a)in clinical practice:a biomarker whose time has come.A scientific statement from the National Lipid Association[J].JClin Lipidol, 2019,13(3):374-392.
[6] Jang AY, Han SH, Sohn IS, et al. Lipoprotein(a) and cardiovascular diseases - revisited[J].CircJ, 2020,84(6):867-874.
[7] 徐娜. 血清脂蛋白(a)与冠心病患者冠脉严重程度及远期预后的相关性研究[D].北京:北京协和医学院,2020.
[8] Avan A, Tavakoly Sany SB, Ghayour-Mobarhan M, et al. Serum C-reactive protein in the prediction of cardiovascular diseases: Overview of the latest clinical studies and public health practice[J].J Cell Physiol,2018,233(11):8508-8525.
[9] RosensonRS, Brewer HB, Barter PJ, et al. HDL and atherosclerotic cardiovascular disease: genetic insights into complex biology[J]. Nat RevCardiol,2018,15(1):9-19.
[10] 屠思佳,袁红,章慧慧,等.MHR联合Lp(a)对急性心肌梗死患者PCI治疗后短期预后的预测价值[J].心电与循环,2022,41(5):445-449.
[11] Sumarjaya ID, Nagha IB, Lestar AAW. High lipoprotein(a) levels as a predictor of major adverse cardiovascular events in hospitalized-Acute myocardial infarction patients[J].VascHealth Risk Manag,2020,16:125-132.
[12] 薛雅芝,曾晓容,林子祥,等.C反应蛋白高密度脂蛋白胆固醇比值、中性粒细胞淋巴细胞比值对冠心病的预测价值研究[J].中国全科医学,2020,23(25):3194-3199,3206.
[13] 朱泽阳,黄维,王旭颖,等.C反应蛋白与高密度脂蛋白胆固醇比值预测缺血性脑卒中患者颈动脉斑块易损性的诊断价值研究[J].中风与神经疾病杂志,2021,38(8):707-710.
[14] Chen Z, Jiang C, Qu H, et al. Association of lipoprotein(a) and major adverse cardiovascular events in patients with percutaneous coronary intervention[J].Arch Med Sci,2019,15(6):1375-1380.
[15] Takahashi D, Wada H, OGgita M, et al. Impact of lipoprotein(a) as a residual risk factor in long-term cardiovascular outcomes in patients with acutecoronary syndrome treated with statins[J].Am J Cardiol, 2022,168:11-16.
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