残余胆固醇水平对急性冠脉综合征患者发病的预测价值  

Predictive value of residual cholesterol in occurrence of patients with acute coronary syndrome

作　　者：巨名飞[1] 刘超[1] 马志刚 赵娟[2] 王涂 王智昊[3] JU Mingfei;LIU Chao;MA Zhigang;ZHAO Juan;WANG Tu;WANG Zhihao(Department of Emergency Medicine,Affiliated Hospital,Chengde Medical University,Chengde 067000,China;Department of Pathophysiology,Chengde Medical University,Chengde 067000,China;Department of Geriatrics,First Hospital,Jilin University,Changchun 130021,China)

机构地区：[1]承德医学院附属医院急诊医学科,河北承德067000 [2]承德医学院病理生理学教研室,河北承德067000 [3]吉林大学第一医院老年病科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2023年第3期765-769,共5页Journal of Jilin University：Medicine Edition

基　　金：河北省科技厅自然科学基金面上项目(H2020406011);河北省承德市科技局科学技术研究与发展计划项目(202204A028)。

摘　　要：目的:分析急性冠脉综合征(ACS)患者胆固醇水平的变化,探讨残余胆固醇(RC)水平对ACS发病的预测价值。方法:选取ACS患者220例作为ACS组,选取同期健康体验者220名作为对照组。收集2组研究对象的一般资料,包括血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)和高密度脂蛋白胆固醇(HDL-c)水平,计算血清中非HDL-c (non-HDL-c)和RC水平。采用Logistic回归分析ACS患者的危险因素及其与各血脂成分水平的相关性,采用受试者工作特征(ROC)曲线和曲线下面积(AUC)评价各血脂成分对ACS发病的预测价值。结果:单因素分析,与对照组比较,ACS组患者高血压和吸烟者所占百分率明显升高(P<0.01),血清中TC、RC、LDL-c和non-HDL-c水平明显升高(P<0.01),HDL-c水平明显降低(P<0.01)。多因素Logistic回归分析,高血压(OR=0.496,P=0.005)、吸烟(OR=0.458,P=0.002)、RC水平(OR=24.051,P<0.01)和non-HDL-c水平(OR=1.711,P<0.01)是ACS发病的独立危险因素。ROC曲线分析,与nonHDL-c水平比较,RC水平的AUC较大,对ACS患者发病的预测价值更高。结论:RC水平是ACS发病的独立危险因素,对ACS发病具有一定预测价值。Objective:To analyze the changes of cholesterol levels of the patients with acute coronary syndrome(ACS),and to explore the predictive value of residual cholesterol(RC)levels in the occurrence of ACS.Methods:A total of 220 ACS patients were selected as ACS group;220 healthy people underwent physical examination at the same time were selected as control group.The general informations including serum levels of total cholesterol(TC),low density lipoprotein cholesterol(LDL-c)and high density lipoprotein cholesterol(HDL-c)of the subjects in two groups were collected,and the levels of serum non-high density lipoprotein cholesterol(non HDL-c)and serum residual cholesterol(RC)were calculated.Logistic regression analysis was used to analyze the risk factors of the ACS patients and their correlations with the levels of various lipid components.The receiver operating characteristic curve(ROC)and the area under(AUC)were used to evalue the predictive values of various blood lipid components in the ACS.Results:The single factor analysis results showed that compared with control group,the percentages of the patients with hypertension and smoking in ACS group were increased(P<0.01),the levels of TC,RC,LDL-c,non HDL-c of the patients in ACS group were increased(P<0.01),and the level of HDL-c was decreased(P<0.01).The multivariate Logistic regression analysis results showed that hypertension(OR=0.496,P=0.005),smoking(OR=0.458,P=0.002),RC level(OR=24.051,P<0.01),and non HDL-c level(OR=1.711,P<0.01)were the independent risk factors for the occurrence of ACS.The ROC curve analysis results show that compared with non-HDL-c level,the AUC of RC level was larger,which had the higher predictive value for the occurrence of the ACS patients.Conclusion:RC level is an independent risk factor for the occurrence of ACS,and has certain predictive value for the occurrence of ACS.

关 键 词：急性冠脉综合征 血脂 残余胆固醇 危险因素 

分 类 号：R543.3[医药卫生—心血管疾病]