血浆致动脉硬化指数对冠心病远期预后的评估价值  

Evaluation value of atherogenic index of plasma for long-term prognosis of coronary artery disease

作　　者：赵永亮[1] 张韶辉[2] 苏强[3] 戴雯[2] 刘立新[2] 杨国良[2] 陈安勇[2] 陈雪英 Zhao Yongliang;Zhang Shaohui;Su Qiang;Dai Wen;Liu Lixin;Yang Guoliang;Chen Anyong;Chen Xueying(Department of Cardiosurgery,Affiliated Hospital of Jining Medical University,Jining 272029,China;Department of Cardiology,Affiliated Hospital of Jining Medical University,Jining 272029,China;Health Management Center,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院心外科,济宁272029 [2]济宁医学院附属医院心内科,济宁272029 [3]济宁医学院附属医院健康管理中心,济宁272029

出　　处：《中国医师杂志》2022年第8期1204-1209,共6页Journal of Chinese Physician

基　　金：山东省医药卫生科技发展计划项目(2019WS367)。

摘　　要：目的明确血浆致动脉硬化指数(AIP)对冠心病远期预后的评估价值。方法回顾性分析2013年5月至2015年11月济宁医学院附属医院住院行冠状动脉造影的冠心病患者2500例,依据AIP值的高低,将研究对象分为低AIP组(AIP<0.06)和高AIP组(AIP≥0.06)。比较两组患者的主要不良心血管事件(MACE)的发生率,用Kaplan-Meier法评估无MACE事件的生存率,多因素Cox生存分析评价MACE的独立预测因子。结果研究完成随访2427例,随访率为97.08%,随访时间中位数4.29年。低AIP组1123例,高AIP组1304例,其中624例患者(25.7%)发生了MACE事件,高AIP组的总MACE发生率高于低AIP组(HR:1.43,95%CI:1.22~1.68,P<0.01);Kaplan-Meier曲线发现高AIP组的无MACE事件生存率明显更低(P<0.01);在调整了多个混杂因素后AIP仍然与冠心病患者的预后有关,AIP升高(≥0.06)是冠心病患者4年间发生MACE的独立预测因子(HR:1.34,95%CI:1.14~1.58,P<0.01)。结论AIP升高(≥0.06)是预测冠心病患者4年间发生MACE的独立预测因子,AIP对冠心病患者的远期预后具有一定的评估价值。Objective To determine the predictive value of atherogenic index of plasma(AIP)on the long-term prognosis of patients with coronary artery disease(CAD).Methods A total of 2500 patients with coronary heart disease who underwent coronary angiography in Affiliated Hospital of Jining Medical University from May 2013 to November 2015 were retrospectively analyzed.According to the AIP value,the subjects were divided into low AIP group(AIP<0.06)and high AIP group(AIP≥0.06).The incidence of major adverse cardiovascular events(MACE)was compared between the two groups.Kaplan-meier method was used to evaluate the MACE-free survival rate,and multivariate Cox survival analysis was used to evaluate the independent predictors of MACE.Results A total of 2427 patients were followed up,with a follow-up rate of 97.08%and a median follow-up time of 4.29 years.There were 1123 cases in the low AIP group and 1304 cases in the high AIP group,among which 624 patients(25.7%)had MACE.The total incidence of MACE in the high AIP group was higher than that in the low AIP group(HR=1.43,95%CI:1.22-1.68,P<0.01).Kaplan-meier curves showed that the MACE-free survival rate was significantly lower in the high AIP group(P<0.01).After adjusting for multiple confounding factors,AIP was still associated with the prognosis of CHD patients.Increased AIP(≥0.06)was an independent predictor of MACE in CHD patients within 4 years(HR=1.34,95%CI:1.14-1.58,P<0.01).Conclusions AIP(≥0.06)was an independent predictor of MACE occurrence in patients with CAD within 4 years.AIP has a certain value in the long-term prognosis of patients with CAD.

关 键 词：冠心病 血浆致动脉硬化指数 甘油三酯 高密度脂蛋白胆固醇 主要不良心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]