3种指标与颈椎病围手术期主要不良心脏事件的相关性分析  

Correlation analysis between three indicators and adverse cardiac events in perioperative period of cervical spondylosis

作　　者：张鑫[1] 王慧[1] 刘肃[1] 马朋朋[1] 蔡明 张春玲[1] ZHANG Xin;WANG Hui;LIU Su;MA Peng-peng;CAI Ming;ZHANG Chun-ling(Dept of Orthopaedic Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院骨外科,河北张家口075000

出　　处：《临床骨科杂志》2023年第5期645-648,共4页Journal of Clinical Orthopaedics

基　　金：河北省张家口市科技局重点研发计划项目(编号:2021107D)。

摘　　要：目的探讨Charlson合并症指数(CCI)、氧合酶-1(HO-1)、脂蛋白关联磷脂酶A2(LpPLA2)与颈椎病围手术期主要不良心脏事件(MACE)的相关性。方法将择期行颈椎手术的100例颈椎病患者按照围手术期是否发生MACE分为MACE组(34例)与非MACE组(66例),另选择同期50例健康体检志愿者作为对照组。比较3组CCI、HO-1及LpPLA2,采用Spearman分析法进行相关性分析,采用logistic回归分析法进行多因素分析,并绘制受试者工作特征曲线分析各指标对MACE的预测效能。结果①CCI、HO-1、LpPLA2:MACE组明显高于非MACE组和对照组,差异均有统计学意义(P<0.05);非MACE组与对照组比较差异均无统计学意义(P>0.05)。②MACE与CCI(r=0.529,P=0.024)、HO-1(r=0.632,P=0.015)、LpPLA2(r=0.515,P=0.027)均呈正相关性。③CCI>3分、HO-1>400μg/L、LpPLA2>70μg/L为影响颈椎病围手术期发生MACE的危险因素(P<0.05)。④CCI、HO-1、LpPLA23项联合检测的AUC面积、敏感度、特异度及约登指数均高于单项对MACE的预测结果(P<0.05)。结论CCI、HO-1、LpPLA2在颈椎病围手术期MACE患者中均呈高水平表达,均可作为颈椎病围手术期MACE的预测因子,且3项联合检测的预测效能更高。CCI>3分、HO-1>400μg/L、LpPLA2>70μg/L均为影响颈椎病围手术期发生MACE的危险因素。Objective To investigate the correlation of Charlson comorbidity index(CCI),oxygenase-1(HO-1),lipoprotein associated phospholipase A2(LpPLA2)and major adverse cardiac events(MACE)during perioperative period of cervical spondylosis.Methods The 100 patients with cervical spondylosis who were selected for cervical surgery were divided into MACE group(34 cases)and non MACE group(66 cases),according to whether MACE occurred in the perioperative period,and 50 healthy volunteers were selected as the control group.CCI,HO-1 and LpPLA2 were compared among three groups,Spearman analysis was used for correlation analysis.Logistic regression analysis was used for multivariate factors analysis.Receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of single and combined detection of CCI,serum HO-1 and LpPLA2 concentration for MACE.Results①CCI,HO-1 and LpPLA2:MACE group was significantly higher than non MACE group and control group(P<0.05);there was no significant difference between the non MACE group and the control group(P>0.05).②MACE was positively correlated with CCI(r=0.529,P=0.024),HO-1(r=0.632,P=0.015)and LpPLA2(r=0.515,P=0.027).③CCI>3 points,HO-1>400μg/L,LpPLA2>70μg/L were the risk factors of MACE in the perioperative period of cervical surgery(P<0.05).④The AUC area,sensitivity,specificity and Youden index of the combined detection of CCI,HO-1 and LpPLA2 were higher than those of single item in the prediction of MACE(P<0.05).Conclusions CCI,HO-1 and LpPLA2 are highly expressed in patients with MACE during the perioperative period of cervical spondylosis,and they can all be used as predictors of MACE during the perioperative period of cervical spondylosis,and the combined detection of the three items has a higher predictive efficiency.CCI>3 points,HO-1>400μg/L,LpPLA2>70μg/L are risk factors for MACE in the perioperative period of cervical spondylosis.

关 键 词：Charlson合并症指数 氧合酶-1 脂蛋白关联磷脂酶A2 颈椎病 不良心脏事件 相关性 

分 类 号：R446.1[医药卫生—诊断学] R681.5[医药卫生—临床医学] R541