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非高密度脂蛋白胆固醇与急性冠脉综合征患者早期再发主要心血管事件的关系及其临床意义

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第6期
页码:
704-707
栏目:
临床研究
出版日期:
2016-07-05

文章信息/Info

Title:
Clinical value and study on the relationship between non-high-density lipoprotein cholesterol and early major adverse cardiovascular events in patients with acute coronary syndrome
作者:
陈思锐1; 张利华1; 刘 军1; 任引刚1; 康 黎1; 牛晓琳2
（第四军医大学唐都医院：1.老年病科，2.心内科，陕西 西安 710038）
Author(s):
CHEN Si-rui1;  ZHANG Li-hua1;  LIU Jun1;  REN Yin-gang1;  KANG Li1;  NIU Xiao-lin2
(1.Department of Geriatrics, 2.Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi’an 710038, Shaanxi, China)
关键词:
非高密度脂蛋白胆固醇; 主要心血管事件; 急性冠脉综合征
Keywords:
non-high-density lipoprotein cholesterol;  major adverse cardiovascular events;  acute coronary syndrome
分类号:
R541.4;R446.11
DOI:
-
文献标识码:
A
摘要:
目的 分析非高密度脂蛋白胆固醇(Non-HDL-C)与急性冠脉综合征（ACS）患者早期再发主要心血管事件（MACE）的关系，探讨Non-HDL-C对ACS患者早期再发MACE的预测价值。方法 采用病例对照研究方法，收集408例ACS患者入院时临床资料，通过院内观察和院外随访记录发病30 d内再发MACE的情况，根据是否再发MACE将患者分为事件组和非事件组，比较分析两组间各指标的差异。结果 ①事件组的基线Non-HDL-C水平明显高于非事件组〔（3.6±0.7）mmol/L vs.(3.2±0.6)mmol/L,P<0.01〕。②多因素logistic回归分析显示Non-HDL-C、超敏C反应蛋白（hs-CRP）、红细胞分布宽度（RDW）、年龄是再发MACE的危险因素，高密度脂蛋白胆固醇（HDL-C）则是显著的保护因素。③ 受试者工作特征曲线(ROC曲线)显示Non-HDL-C的曲线下面积为0.672(95%CI:0.610-0.735)，当截断点选定3.31 mmol/L时，其预测效率最高，灵敏度为68.3%，特异度为64.3%。结论 Non-HDL-C是ACS患者早期再发MACE的危险因素,对ACS患者早期再发MACE有一定预测价值。
Abstract:
AIM To analyze the relationship between non-high-density lipoprotein cholesterol (non-HDL-C) and early major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). METHODSEnrolled in this study were 408 ACS patients. According to occurrence of MACE, 408 patients were divided into two groups: event group (n=63) and nonevent group (n=345). Serum lipid levels and characteristics of the two groups were analyzed. RESULTSBaseline level of non-HDL-C in patients with MACE was higher than in patients without MACE ［(3.5±0.7) mmol/L vs.(3.1±0.9) mmol/L, P<0.05］. Multivariable logistic regression analysis showed that non-HDL-C, high-sensitivity C-reactive protein (hs-CRP), red blood cell distribution width (RWD) and age are risk factors for MACE. Receiver operating characteristic curve (ROC) analysis showed that the optimal cut-off value of non-HDL-C was 3.31 mmol/L, with a sensitivity of 68.3% and specificity of 64.3%. CONCLUSIONNon-HDL-C is an independent risk factor for ACS and can be used to predict the occurrence of early MACE in ACS patients.

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备注/Memo

备注/Memo:
收稿日期：2015-09-09.
通讯作者：张利华,教授，主要从事心律失常研究Email：zlh1204@sohu.com
作者简介：陈思锐，硕士生Email：chenthree19@sina.com
更新日期/Last Update: 2016-07-10