单核细胞/高密度脂蛋白胆固醇比值与急性ST段抬高型心肌梗死患者短期预后的相关性研究

Relationship between monocyte to high-density lipoprotein cholesterol ratio and short-term prognosis of patients with acute ST-segment elevation myocardial infarction

目的探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)对急性ST段抬高型心肌梗死(STEMI)患者短期预后的预测价值。方法选取2012年1月~2017年6月于上海市徐汇区大华医院就诊并接受急诊经皮冠状动脉治疗的STEMI患者367例,根据患者住院期间是否发生主要不良心脏事件(MACE)将其分为MACE组(n=64)和非MACE组(n=303)。比较两组患者的临床资料,并根据血常规和生化检测结果计算MHR值。结果与非MACE组相比,MACE组患者的MHR水平显著升高[(1.07±0.42)×109 vs.(0.79±0.33)×109],差异具有统计学意义(P<0.01)。随着MHR水平的升高,STEMI患者MACE发生率也逐渐增加(P<0.01)。多因素Logistic回归分析表明,MHR是STEMI患者发生院内MACE的独立预测因素(OR=2.14,95%CI:1.27~3.62;P<0.01)。ROC曲线分析提示,MHR预测院内MACE发生的最佳截点为0.89×109,其敏感性为70.3%,特异性为81.4%。结论 STEMI患者的MHR水平与其院内MACE的发生密切相关,检测MHR可能有助于STEMI早期风险的评估。

Objective To explore the association between monocyte to high-density lipoprotein cholesterol ratio(MHR)and short-term prognosis in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods From January 2012 to June 2017,367 STEMI inpatients received primary percutaneous coronary intervention were included.According to whether or not major adverse cardiac events(MACE)occurred during hospitalization,these patients were divided into the MACE(n=64)group and non-MACE(n=303)group.The MHR value was calculated based on the results of routine blood test and biochemical assay.Results Patients in the MACE group had a significantly higher level of MHR than those in the non-MACE group[(1.07±0.42)×109/mmol vs.(0.79±0.33)×109/mmol;P<0.01].The occurrence rate of MACE was also increased along with the elevated MHR level(P<0.05).Multivariate logistic regression analysis indicated that MHR was an independent predictor of in-hospital MACE in STEMI patients(OR=2.14,95%CI:1.27~3.62;P<0.01).ROC curve analysis indicated that the optimum cutoff value of MHR in the prediction of in-hospital MACE was 0.89×109/mmol,with a sensitivity of 70.3%and a specificity of 81.4%.Conclusion In patients with STEMI,the level of MHR is closely associated with the occurrence of in-hospital MACE.Measurement of MHR may be useful for the early risk evaluation of STEMI patients.