| 摘要: |
| ［摘要］ 目的 分析富含甘油三酯脂蛋白（TGRLs）水平对老年非糖尿病性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入治疗（PCI）术后临床结局的影响。方法 回顾性分析2018年2月至2020年10月青海省心脑血管病专科医院收治的311例非糖尿病性STEMI患者的临床资料，均接受冠状动脉造影（CAG）和PCI。PCI前采集患者血液样本进行TGRLs水平检测，随访观察PCI后患者主要不良心血管事件（MACE）和全因死亡的发生情况。结果 多因素Cox回归分析结果显示，较高的入院时全球急性冠状动脉事件注册（GRACE）评分和TGRLs水平是促进患者发生MACE的独立危险因素（P<0.05）；较高水平的TGRLs是促进患者发生全因死亡的独立危险因素（P<0.05）。ROC曲线分析结果显示，TGRLs水平可有效预测患者术后MACE［AUC(95%CI)=0.825(0.749～0.902)］和全因死亡［AUC(95%CI)=0.910(0.858～0.962)］的发生情况(P<0.001)，其预测MACE发生的最佳截断值为0.835 mmol/L，对应的灵敏度和特异度分别为73.3%、79.7%；预测全因死亡发生的最佳截断值为0.885 mmol/L，对应的灵敏度和特异度分别为83.3%、86.7%。结论 高TGRLs水平是促进老年非糖尿病性STEMI患者PCI术后发生MACE和全因死亡的危险因素，有助于指导临床对患者进行分级管理。 |
| 关键词: 富含甘油三酯脂蛋白 非糖尿病性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 主要不良心血管事件 全因死亡 |
| DOI：10.3969/j.issn.1674-3806.2023.08.08 |
| 分类号:R 542.2+2 |
| 基金项目:青海省科技计划项目（编号：2019-ZJ-7096） |
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| Analysis on effect of levels of triglyceride-rich lipoproteins on clinical outcomes in elderly patients with non-diabetic STEMI after percutaneous coronary intervention |
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HAN Xiao-juan, YAN Zhan-guang, HOU Hai-wen
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The First Department of Coronary Heart Disease, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Xining 810000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the effect of levels of triglyceride-rich lipoproteins(TGRLs) on clinical outcomes in elderly patients with non-diabetic ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI). Methods The clinical data of 311 non-diabetic STEMI patients admitted to Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital from February 2018 to October 2020 were retrospectively analyzed, all of whom received coronary angiography(CAG) and PCI. The patients′ blood samples were collected before PCI for detection of levels of TGRLs, and the patients were followed up after PCI and their incidence of major adverse cardiovascular events(MACE) and all-cause mortality were observed. Results The results of multivariate Cox regression analysis showed that higher Global Registry of Acute Coronary Event(GRACE) scores and levels of TGRLs at admission were independent risk factors for MACE(P<0.05); higher levels of TGRLs were an independent risk factor for all-cause mortality(P<0.05). The results of receiver operating characteristic(ROC) curve analysis showed that levels of TGRLs could effectively predict the occurrence of MACE［AUC(95%CI)=0.825(0.749-0.902)］ and all-cause mortality［AUC(95%CI)=0.910(0.858-0.962)］ after surgery(P<0.001), and the best cut-off value for predicting MACE was 0.835 mmol/L, and the corresponding sensitivity and specificity were 73.3% and 79.7%, respectively; the best cut-off value for predicting all-cause mortality was 0.885 mmol/L, and the corresponding sensitivity and specificity were 83.3% and 86.7%, respectively. Conclusion High level of TGRLs is a risk factor for MACE and all-cause mortality after PCI in elderly non-diabetic STEMI patients, which is helpful to guide the clinical grading management of the patients. |
| Key words: Triglyceride-rich lipoproteins(TGRLs) Non-diabetic ST-segment elevation myocardial infarction(STEMI) Percutaneous coronary intervention(PCI) Major adverse cardiovascular events(MACE) All-cause mortality |
