早发冠心病患者发病的危险因素及RLP-C、AIP对短期预后的预测价值  

Predisposing risk factors and predictive value of remnant-like lipoprotein-cholesteroland atherogenic index of plasma to short-term prognosis in patients with premature coronary artery disease

作　　者：段文娟 任保军[2] 崔国峰[2] 武云涛 Duan Wenjuan;Ren Baojun;Cui Guofeng;Wu Yuntao(Department of Rehabilitation Medicine,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China;不详)

机构地区：[1]内蒙古医科大学附属医院康复医学科,呼和浩特010050 [2]内蒙古医科大学附属医院心血管内科,呼和浩特010050 [3]解放军总医院第七医学中心老年医学科,北京100700

出　　处：《中国循证心血管医学杂志》2024年第7期782-784,817,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：军队保健专项课题(15BJ203)。

摘　　要：目的探讨早发冠状动脉粥样硬化性心脏病(冠心病)患者发病的危险因素及残粒样脂蛋白-胆固醇(RLP-C)、血浆致动脉粥样硬化指数(AIP)对短期预后的预测价值。方法回顾性分析2022年1月至2024年1月于内蒙古医科大学附属医院就诊的120例早发冠心病患者作为观察组,另选择同期本院体检的健康人群100例作为对照组。分析早发冠心病患者发病的危险因素,并比较观察组不同预后患者RLP-C、AIP水平,采用受试者工作曲线(ROC)分析RLP-C、AIP及联合检测对早发冠心病患者短期预后的预测价值。结果多因素Logistic回归分析显示,体质指数(BMI)、高血压、吸烟、冠心病家族史、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、RLP-C、AIP均是早发冠心病患者发病的危险因素(P<0.05)。随访6个月,观察组预后不良组11例、预后良好组109例,预后不良组RLP-C、AIP均高于预后良好组,差异有统计学意义(P<0.05)。ROC分析显示,RLP-C、AIP联合检测对早发冠心病患者短期预后的预测价值[曲线下面积(AUC):0.992,95%CI:0.981~1.000]均高于RLP-C(AUC:0.927,95%CI:0.862~0.993)、AIP(AUC:0.982,95%CI:0.955~1.000)单独检测。结论早发冠心病患者发病的危险因素较多,且RLP-C、AIP联合检测对患者短期预后具有较好的预测价值。Objective To investigate the predisposing risk factors and predictive value of remnant-like lipoprotein-cholesterol(RLP-C)and atherogenic index of plasma(AIP)to short-term prognosis in patients with premature coronary artery disease(PCAD).Methods PCAD patients(n=120)were retrospectively chosen into observation group and healthy controls were chosen into control group(n=100)from Affiliated Hospital of Inner Mongolia Medical University from Jan.2022 to Jan.2024.The predisposing risk factors for PCAD were analyzed,and levels of RLP-C and AIP were compared in patients with different prognosis in observation group.The predictive value of RLP-C,AIP and combination of RLP-C and AIP to short-term prognosis in PCAD patients were analyzed by using ROC curve.Results The results of multi-factor Logistic regression analysis showed that body mass index(BMI),hypertension,smoking,family history of coronary heart disease(CHD),triglyceride(TG),total cholesterol(TC),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C),RLP-C and AIP all were predisposing risk factors for PCAD(P<0.05).After followed up for 6 months,there were 11 patients in poor prognosis group and 109 in good prognosis group in observation group.The levels of RLP-C and AIP were higher in poor prognosis group than those in good prognosis group(P<0.05).The results of ROC curve analysis showed that the predictive value of combination of RLP-C and AIP(AUC=0.992,95%CI:0.981~1.000)were higher than that of only RLP-C(AUC=0.927,95%CI:0.862-0.993)or only AIP(AUC=0.982,95%CI:0.955~1.000)in detecting short-term prognosis in PCAD patients.Conclusion There are many predisposing risk factors for PCAD,and combination of RLP-C and AIP has a higher predictive value in detecting short-term prognosis in PCAD patients.

关 键 词：早发冠心病 残粒样脂蛋白-胆固醇 致动脉粥样硬化指数 预后 

分 类 号：R541.4[医药卫生—心血管疾病]