血清同型半胱氨酸对老年急性冠状动脉综合征患者经皮冠状动脉介入治疗后心血管不良事件的预测价值  

The predictive value of serum homocysteine for adverse events after percutaneous coronary intervention in elderly patients with acute coronary syndrome

作　　者：胡铧予 娄冬梅[2] 鲁硕[2] Hu Huayu;Lou Dongmei;Lu Shuo(Changchun University of Chinese Medicine,Changchun 130117;Changchun Central Hospital,Changchun 130051)

机构地区：[1]长春中医药大学,长春130117 [2]长春市中心医院,长春130051

出　　处：《国际老年医学杂志》2025年第2期146-149,共4页International Journal of Geriatrics

基　　金：吉林省卫生健康科技能力项目(2023LC095)。

摘　　要：目的血清同型半胱氨酸(Hcy)对老年急性冠状动脉综合征患者经皮冠状动脉介入治疗(PCI)后30 d内发生主要心血管不良事件(MACE)的预测价值。方法选取2023年10月-2024年3月长春市中心医院收治的153例老年急性冠状动脉综合征患者进行前瞻性研究,PCI后第1天开始随访30 d,根据MACE发生情况分为发生组和未发生组。多因素logistic回归模型分析MACE发生的影响因素,ROC曲线分析血清Hcy对PCI后发生MACE的预测价值。结果共27例患者发生MACE,发生组Hcy、低密度脂蛋白胆固醇(LDL-C)、血清尿酸(UA)水平高于未发生组,差异有统计学意义(P<0.05);多因素logistic回归分析表明,Hcy、UA、LDL-C均为老年急性冠状动脉综合征患者PCI后发生MACE的独立危险因素(P<0.05);ROC曲线显示,Hcy对老年急性冠状动脉综合征患者PCI后发生MACE有一定的预测价值,曲线下面积为0.687(95%CI:0.558~0.815,P=0.002)。结论血清Hcy是老年急性冠状动脉综合征患者PCI后短期内发生MACE的危险因素,对MACE的发生具有一定的预测价值。Objective To investigate the predictive value of serum homocysteine(Hcy)for the occurrence of major adverse cardiovascular events(MACE)within 30 days after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS).Methods A prospective study was conducted in 153 elderly patients with acute coronary syndrome admitted to Changchun Central Hospital from October 2023 to March 2024.The patients were followed up for 30 days on the first day after PCI.The patients were divided into an occurrence group and a non-occurrence group according to the occurrence of MACE.Multivariate logistic regression model was used to analyze the influencing factors of MACE,and ROC curve was used to analyze the predictive value of serum Hcy for the occurrence of MACE after PCI.Results Twenty-seven patients developed MACE,and the levels of Hcy,low density lipoprotein cholesterol(LDL-C),and uric acid(UA)in the group that developed MACE were higher than those in the group that did not develop MACE(P<0.05);multivariate logistic regression analysis showed that Hcy,UA,and LDL-C were all independent risk factors for MACE after PCI in elderly patients with acute coronary syndrome(P<0.05);ROC curves showed that Hcy had a certain predictive mechanism for MACE after PCI in elderly patients with acute coronary syndrome,with an area under the curve of 0.687(95%CI:0.558-0.815,P=0.002).Conclusion Serum Hcy is a risk factor for MACE in elderly patients with acute coronary syndrome in the short term after PCI,and it has some predictive value for the occurrence of MACE.

关 键 词：同型半胱氨酸 急性冠状动脉综合征 经皮冠状动脉介入治疗 主要心血管不良事件 

分 类 号：R54[医药卫生—心血管疾病]