冠心病患者CABG术后Hct、LP(a)、MPV动态变化情况及其与血管内皮功能的相关性  

Dynamic Changes in Hct,LP(a),MPV and their Correlation with Vascular Endothelial Function in Patients with Coronary Heart Disease after CABG Surgery

作　　者：邓楚滢 王晓慧 李纯 DENG Chuying;WANG Xiaohui;LI Chun(The Ninth People's Hospital of Zhengzhou,Zhengzhou Henan 450000)

机构地区：[1]郑州市第九人民医院,河南郑州450000

出　　处：《医学临床研究》2024年第2期262-264,268,共4页Journal of Clinical Research

摘　　要：【目的】探讨冠心病患者冠状动脉旁路移植术(CABG)术后红细胞比容(Hct)、脂蛋白(a)[LP(a)]、血小板平均体积(MPV)动态变化情况及其与血管内皮功能的相关性。【方法】选取2020年1月至2022年12月于本院行非体外循环CABG治疗的89例冠心病患者,根据术后90 d是否发生心绞痛分为心绞痛组(n=30)和非心绞痛组(n=59)。比较两组患者术前、术后4 d、术后14 d的Hct、LP(a)、MPV水平及血管内皮功能指标变化[内皮素1(ET-1)、一氧化氮(NO)]。分析术后4 d、术后14 d Hct、LP(a)、MPV水平与ET-1、NO相关性,分析Hct、LP(a)、MPV水平对CABG术后再发心绞痛的预测价值。【结果】两组患者术后4 d、术后14 d的Hct、LP(a)、MPV水平均低于术前,且非心绞痛组低于心绞痛组,差异有统计学意义(P<0.05)。术后4 d、术后14 d,两组患者ET-1水平低于术前,NO水平高于术前,差异均有统计学意义(P<0.05);非心绞痛组ET-1、NO水平与心绞痛组比较,差异均有统计学意义(P<0.05)。Pearson相关性分析显示,术后4 d、术后14 d的Hct、LP(a)、MPV与ET-1呈正相关(P<0.05),与NO呈负相关(P<0.05)。受试者工作特征曲线分析显示,Hct、LP(a)、MPV联合预测CABG术后发生心绞痛的曲线下面积大于单项指标预测(P<0.05)。【结论】冠心病患者CABG术后Hct、LP(a)、MPV动态变化情况与血管内皮功能相关,Hct、LP(a)、MPV联合预测CABG术后再发心绞痛的临床应用价值较高。【Objective】To explore the dynamic changes in hematocrit(Hct),lipoprotein(a)[LP(a)],mean platelet volume(MPV),and their correlation with vascular endothelial function in patients with coronary heart disease after coronary artery bypass grafting(CABG).【Methods】A total of 89 patients with coronary heart disease who underwent non extracorporeal circulation CABG surgery in our hospital from January 2020 to December 2022 were selected.They were divided into an angina group(n=30)and a non angina group(n=59)based on whether angina occurred 90 days after surgery.We compared the changes in Hct,LP(a),MPV levels,and vascular endothelial function indicators[endothelin-1(ET-1),nitric oxide(NO)]between two groups of patients before surgery,4 days after surgery,and 14 days after surgery.The correlation between Hct,LP(a),MPV levels and ET-1 and NO was analyzed at postoperative 4 days and 14 days,and the predictive value of Hct,LP(a),and MPV levels for recurrent angina after CABG was analyzed.【Results】The Hct,LP(a),and MPV levels of the two groups of patients were lower than before surgery on the 4th and 14th postoperative days,and the non angina group was lower than the angina group,with statistical significance(P<0.05).At postoperative 4 days and 14 days,the levels of ET-1 in both groups were lower than before surgery,while the levels of NO were higher than before surgery,and the differences were statistically significant(P<0.05);The levels of ET-1 and NO in the non angina group were significantly different from those in the angina group(P<0.05).Pearson correlation analysis showed that Hct,LP(a),MPV were positively correlated with ET-1(P<0.05)and negatively correlated with NO(P<0.05)at postoperative 4 days and 14 days.The analysis of the working characteristic curve of the subjects showed that the area under the curve of Hct,LP(a),and MPV combined prediction for postoperative angina pectoris in CABG was greater than that of single prediction(P<0.05).【Conclusion】The dynamic changes of Hct,LP(a),and MPV in patients

关 键 词：冠状动脉分流术 脂蛋白(A) 平均血小板体积 内皮 血管 

分 类 号：R541.4[医药卫生—心血管疾病]