血清MDA-LDL、ALP与急性冠脉综合征患者PCI术后不良心血管事件的关系  

Analysis of the relationship between serum MDA-LDL,ALP and major adverse cardiovascular events in patients with acute coronary syndrome after PCI

作　　者：谢志江[1] 李敏[1] 程瑞丽 齐杰 XIE Zhijiang;LI Min;CHENG Ruili;QI Jie(First Department of Internal Medicine-Cardiovascular,Handan First Hospital of Hebei Province,Handan,Hebei 056000,China)

机构地区：[1]河北省邯郸市第一医院心内一科,河北邯郸056000

出　　处：《国际检验医学杂志》2021年第22期2729-2734,共6页International Journal of Laboratory Medicine

基　　金：河北省邯郸市科学技术研究与发展计划(1723208066)。

摘　　要：目的探讨血清丙二醛修饰的低密度脂蛋白(MDA-LDL)和碱性磷酸酶(ALP)与急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后不良心血管事件(MACEs)的关系。方法选取2017年5月至2018年10月该院收治的ACS患者共266例,入院次日检测血清MDA-LDL、ALP水平,随访1年,统计失访人数(4例)及MACEs情况,按照是否发生MACEs将患者分为发生MACEs组(60例)和未发生MACEs组(202例),比较两组临床资料;采用多因素Logistic回归分析MACEs发生的危险因素;采用受试者工作特征曲线分析MDA-LDL、ALP和N末端B型利钠肽原(NT-proBNP)预测MACEs的价值。结果262例ACS患者中MACEs发生率为22.90%(60/262);发生MACEs组患者的年龄、有高脂血症史和慢性阻塞性肺疾病史患者所占比例、C反应蛋白、肌酸激酶、肌酸激酶同工酶、NT-proBNP、MDA-LDL和ALP水平与未发生MACEs组比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析显示,高脂血症史、慢性阻塞性肺疾病史、NT-proBNP、MDA-LDL和ALP水平升高是ACS患者PCI术后发生MACEs的危险因素。血清MDA-LDL、ALP和NT-proBNP单独及联合检测预测MACEs发生的曲线下面积分别为0.770、0.730、0.724和0.852。结论血清高水平MDA-LDL、ALP的ACS患者PCI术后更易发生MACEs,血清MDA-LDL、ALP和NT-proBNP联合检测或可作为临床预测ACS患者PCI术后MACEs发生风险的辅助手段。Objective To investigate the relationship between serum malondialdehyde-modified low-density lipoprotein(MDA-LDL)and alkaline phosphatase(ALP)levels and major adverse cardiovascular events(MACEs)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 266 ACS patients admitted to the hospital from May 2017 to October 2018 were selected.The serum MDA-LDL and ALP levels were measured on the second day of admission.The follow-up was 1 year,4 patients were lost to follow-up and MACEs were counted according to whether MACEs occurred,and then 60 patiens were divided into MACEs group and 202 patients were divided into non-MACEs group,multivariate Logistic regression analysis was used to analyze the influencing factors of MACEs;receiver operating characteristic curve was used to determine the effect of MDA-LDL,ALP and NT-proBNP in predicting MACEs.Results The incidence of MACEs in the 262 ACS patients was 22.90%(60/262);the age of the MACEs group,the proportion of patients with hyperlipidemia and chronic obstructive pulmonary disease,C-reaction protein,creatine kinase,CK-MB,NT-proBNP,MDA-LDL and ALP levels were different from those in the non-MACEs group(P<0.05);multivariate Logistic regression analysis shows that hyperlipidemia,chronic obstructive pulmonary disease,elevated levels of NT-proBNP,MDA-LDL and ALP were the independent risk factors for MACEs.The area under the curve of serum MDA-LDL,ALP and NT-proBNP and the combined detection of the three indicators to predict the occurrence of MACEs were 0.770,0.730,0.724 and 0.852 respectively.Conclusion ACS patients with high serum levels of MDA-LDL and ALP are more likely to develop MACEs after PCI,and the combined detection of serum MDA-LDL,ALP and NT-proBNP might be used as an auxiliary means to clinically predict the risk of MACEs in ACS patients after PCI.

关 键 词：急性冠状动脉综合征 丙二醛修饰的低密度脂蛋白 碱性磷酸酶 经皮冠状动脉介入治疗 不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]