血清ApoA-1、ApoB和Lp(a)水平对急性心肌梗死患者PCI术后MACE的预测分析  

Predictive analysis of serum ApoA-1,ApoB and Lp(a)levels for MACE after PCI in patients with acute myocardial infarction

作　　者：纪静 卢倩 孙文 JI Jing;LU Qian;SUN Wen(Mengcheng County Hospital of Chinese Medicine,Bozhou Anhui 233500,China)

机构地区：[1]蒙城县中医院,安徽亳州233500 [2]安徽省立医院,安徽合肥230000

出　　处：《中国急救复苏与灾害医学杂志》2024年第9期1125-1128,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2021年安徽省重点研究与开发项目(编号:202104J07020049)。

摘　　要：目的探讨血清载脂蛋白A1(ApoA-1)、载脂蛋白B(ApoB)和脂蛋白a[Lp(a)]水平对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后主要心血管不良事件(MACE)的预测效果。方法回顾性分析2020年1月—2022年4月本医院行PCI手术的120例AMI患者的临床资料,根据患者的预后情况分为MACE组(n=28)和无MACE组(n=92)。两组患者临床资料单因素分析,采用Pearson法分析血清ApoA-1、ApoB、Lp(a)与MACE的相关性,采用二元Logistic多因素分析血清ApoA-1、ApoB、Lp(a)对MACE的预测价值。结果MACE组患者ApoA-1水平低于无MACE组,ApoB、Lp(a)水平高于无MACE组(P<0.05);血清ApoA-1水平与MACE呈负相关性,Lp(a)、ApoB水平与MACE呈正相关性(P<0.05);多因素Logistic回归分析结果显示,血清ApoA-1、ApoB、Lp(a)均是MACE的影响因素(P<0.05)。受试者工作特征(ROC)曲线分析血清ApoA-1、ApoB、Lp(a)及联合检测的曲线下面积(AUC)分别为0.675、0.616、0.659、0.886。结论血清ApoA-1、ApoB、Lp(a)及联合检测对AMI患者PCI术后发生MACE具有较好的预测作用,有助于临床制定防治方案,降低患者死亡风险。Objective To explore the predictive effect of serum apolipoprotein A1(ApoA-1),apolipoprotein B(ApoB),and lipoprotein a[Lp(a)]levels on major cardiovascular adverse events(MACE)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Clinical data of 120 AMI patients who underwent PCI surgery in our hospital from January 2020 to April 2022 were retrospectively analyzed.According to their prognosis,they were divided into two groups:the MACE group(n=28)and the non MACE group(n=92).Single factor analysis of clinical data from two groups of patients,Pearson method was used to analyze the correlation between serum ApoA-1,ApoB,Lp(a)and MACE,and binary logistic multivariate analysis was used to predict the predictive value of serum ApoA-1,ApoB,Lp(a)for MACE.Results Compared with patients in the non MACE group,the level of ApoA-1 in MACE group was significantly lower,and the levels of ApoB and Lp(a)were significantly higher(P<0.05);Serum ApoA-1 level was negatively correlated with MACE,while Lp(a)and ApoB levels were positively correlated with MACE(P<0.05);Multivariate logistic regression analysis showed that serum ApoA-1,ApoB,Lp(a)were all the influencing factors of MACE(P<0.05).ROC curve analysis showed that the AUC of serum ApoA-1,ApoB,Lp(a)and combined detection were 0.675,0.616,0.659,0.886 respectively.Conclusion Serum ApoA-1,ApoB,Lp(a),and their combined detection have a good predictive effect on the occurrence of MACE in AMI patients after PCI,which helps to develop clinical prevention and treatment plans and reduce the risk of patient mortality.

关 键 词：载脂蛋白A1 脂蛋白a 载脂蛋白B 急性心肌梗死 经皮冠状动脉介入术 主要心血管不良事件 预测 

分 类 号：R542.22[医药卫生—心血管疾病] R446.1[医药卫生—内科学]