非高密度胆固醇与残粒胆固醇对早发急性心肌梗死预后的预测价值  

The value of non-HDL cholesterol and residual cholesterol in predicting the prognosis of early onset acute myocardial infarction

作　　者：吴楠 朱志勇 Wu Nan;Zhu Zhiyong(Pingdingshun Pingmei Shenma Group General Hospital , Pingdingshan 4625009 Henan, China)

机构地区：[1]平煤神马医疗集团总医院,河南平顶山462500

出　　处：《临床心身疾病杂志》2019年第5期35-38,共4页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨非高密度脂蛋白胆固醇与残粒胆固醇对早发急性心肌梗死患者发生不良心血管事件及预后的预测价值.方法对125例早发急性心肌梗死患者出院后进行为期6 a的随访;根据患者是否发生不良心血管事件分为心血管不良事件组和非心血管不良事件组,比较两组总胆固醇、非高密度胆固醇、残粒胆固醇和载脂蛋白B的表达水平与发生血管不良事件的相关性.结果随访6 a期间本组125例出现不良心血管事件40例(32.0%);心血管不良事件组出现家族性混合型高脂血症表型25例(62.5%),非心血管不良事件组出现16例(18.8%),两组比较差异有统计学意义(P<0.01);心血管不良事件组血清总胆固醇、非高密度胆固醇、残粒胆固醇、三酰甘油、载脂蛋白B水平均显著高于非心血管不良事件组(P<0.05或0.01);单因素分析显示,总胆固醇、残粒胆固醇、非高密度脂蛋白胆固醇、载脂蛋白B、三酰甘油是早发急性心肌梗死患者发生心血管不良事件的危险因素;多因素分析显示,总胆固醇、残粒胆固醇及非高密度脂蛋白胆固醇是早发急性心肌梗死患者发生心血管不良事件的危险因素.结论非高密度脂蛋白胆固醇与残粒胆固醇水平升高的早发急性心肌梗死患者预后较差,非高密度脂蛋白胆固醇与残粒胆固醇是早发急性心肌梗死的始动因素,并可预测主要不良心血管事件的预后结局.Objective To investigate the predictive value of non-HDL cholesterol and residual cholesterol in predicting the prognosis of early onset acute myocardial infarction. Methods 125 patients with early-on- set acute myocardial infarction were followed up for 6 a after discharge. Patients were divided into MACE group and non-MACE group according to whether MACE occurred. The correlation between the expres-sion levels of total cholesterol non-HDL, residual cholesterol,Apo B and vascular adverse events was compared between the two groups. Results During the 6-year follow-up period, there were 40 cases of ad-verse cardiovascular events in 125 patients (32.0%). 25 cases (62. 5%) of familial mixed hyperlipidemia phenotype in the MACE group, 16 cases (18. 8%) in the non-MACE group, and the difference between the two groups was statistically significant (P<0. 01). The serum total cholesterol, non-HDL, residual cholesterol, triglyceride, and Apo B levels in the MACE group were significantly higher than those in the non-MACE group (P<0. 05 or 0. 01). Univariate analysis of MACE incidence showed that total cholester-ol, residual cholesterol, non-HDL, Apo B, and triglyceride were risk factors for cardiovascular adverse e-vents in patients with early-onset acute myocardial infarction. Multivariate analysis of the incidence of MACE showed that total cholesterol, residual cholesterol, and non-HDL were risk factors for cardiovascu-lar adverse events in patients with early-onset acute myocardial infarction. Conclusions Patients with ear-ly-onset acute myocardial infarction with elevated non-HDL and residual cholesterol levels have a poor prognosis. Non-HDL and residual cholesterol are the initiating factors of early onset acute myocardial infarction and can predict the prognostic outcome of major adverse cardiovaseular events.

关 键 词：早发急性心肌梗死 不良心血管事件 非高密度胆固醇 残粒胆固醇 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]