尿酸与同型半胱氨酸对冠心病心绞痛患者PCI术后MACE发生的预测价值

Predictive Value of Uric Acid and Homocysteine for MACE in Patients with Coronary Heart Disease and Angina Pectoris after PCI

目的:分析尿酸(UA)与同型半胱氨酸(Hcy)对冠心病心绞痛患者经皮冠状动脉介入治疗(PCI)术后主要不良心血管事件(MACE)发生的预测价值。方法:选取2020年1月-2021年12月南昌市第三医院收治的60例行PCI治疗的冠心病心绞痛患者为研究对象,根据术后6个月是否发生MACE分为MACE组(n=20)和非MACE组(n=40),记录两组临床资料,检测血浆UA、Hcy水平,采用logistic回归分析影响冠心病心绞痛患者PCI术后发生MACE的危险因素,并采用ROC曲线分析UA、Hcy水平对PCI术后MACE的预测效能。结果:单因素分析显示,MACE组TG、UA、Hcy水平均高于非MACE组,LVEF低于非MACE组,糖尿病比例高于非MACE组(P<0.05);logistic多因素回归分析显示,糖尿病、TG≥1.70 mmol/L、UA≥420μmol/L、LVEF<55%、Hcy≥18μmol/L是冠心病心绞痛患者PCI术后发生MACE的独立危险因素(P<0.05)。ROC曲线分析显示,UA、Hcy水平联合预测冠心病心绞痛患者PCI术后MACE的特异度为100.00%,AUC为0.985,均高于单独检测(P<0.05)。结论:血浆UA、Hcy水平联合对冠心病心绞痛患者PCI术后MACE发生的预测价值较高,可在临床推广应用。

Objective:To analyze the predictive value of uric acid(UA)and homocysteine(Hcy)for major adverse cardiovascular events(MACE)in patients with coronary heart disease and angina pectoris after percutaneous coronary intervention(PCI).Method:A total of 60 patients with coronary heart disease and angina pectoris who underwent PCI in the Third Hospital of Nanchang from January 2020 to December 2021 were selected as the research subjects.According to the presence or absence of MACE in 6 months after operation,the patients were divided into MACE group(n=20)and non-MACE group(n=40).The clinical data of the two groups were recorded.Plasma UA and Hcy levels were detected.Multivariate logistic regression analysis was performed to screen the risk factors of MACE in patients with coronary heart disease and angina pectoris after PCI.ROC curve was used to analyze the performance of UA and Hcy levels in predicting MACE after PCI.Result:Univariate analysis found that the levels of TG,UA and Hcy in MACE group were higher than those in the non-MACE group,and LVEF was lower than that in the non-MACE group,the proportion of diabetes was higher than that in the non-MACE group(P<0.05).Multivariate logistic regression analysis showed that diabetes,TG level≥1.70 mmol/L,UA level≥420μmol/L,LVEF<55%and Hcy≥18μmol/L were independent risk factors for MACE in patients with coronary heart disease and angina pectoris after PCI(P<0.05).ROC curve analysis showed that the specificity of UA and Hcy combined in predicting MACE in patients with coronary heart disease and angina pectoris after PCI was 100.00%,and the AUC was 0.985,which were higher than those of single detection(P<0.05).Conclusion:The combination of plasma UA and Hcy levels has a high predictive value for the occurrence of MACE in patients with coronary heart disease and angina pectoris after PCI.It can be promoted in clinical application.