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。
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.
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