非高密度脂蛋白胆固醇对急性ST段抬高型心肌梗死患者近期预后的影响

Effect of non high density lipoprotein cholesterol on short-term prognosis in patients with acute ST segment elevation myocardial infarction

目的:探讨非高密度脂蛋白(non-HDL-C)对急性ST段抬高型心肌梗死(STEMI)急诊行经皮冠状动脉介入(PCI)术后近期预后的影响。方法:选择住院的STEMI患者276例,对患者进行12个月电话随访及门诊随访,根据是否再次发生心血管不良事件(MACE),将患者分为事件组(发生MACE)及非事件组(未发生MACE)。结果:(1)事件组中non-HDL-C (3. 47±0. 77) mmol/L、TC (4. 48±0. 85) mmol/L、LDL-C (2. 45±0. 72) mmol/L、糖尿病病史(52. 38%)显著高于非事件组中non-HDL-C (2. 92±0. 71) mmol/L,TC (3. 98±0. 76) mmol/L、LDL-C (2. 96±0. 75) mmol/L、糖尿病(30. 67%),两组比较,均存在统计学差异(P <0. 05);(2)不同水平non-HDL-C与再发心血管事件发生率存在显著性相关,其相关系数为0. 339;(3)Longistic回归分析显示non-HDL-C及糖尿病病史是再次发生MACE的危险因素。结论:高水平的non-HDL-C是STEMI患者PCI术后近期预后的重要影响因素,可增加不良心血管事件发生率。

Objective To investigate the effect of non-HDL-C on the short-term prognosis of acute ST-segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI).Method A total of 276 STEMI patients were enrolled in this study.Patients were followed up for 12 months by telephone and outpatient visits.Adverse events(MACE),patients were divided into event group(MACE)and non-event group(non-MACE).Results①The levels of non-HDL-C(3.47±0.77)mmol/L,TC(4.48±0.85)mmol/L and LDL-C(2.45±0.72)mmol/L and diabetes history(52.38%)were higher than non-HDL-C(2.92±0.71)mmol/L,TC(3.98±0.76)mmol/L,LDL-C(2.96±0.75)mmol/L and diabetes history(30.67%)in non-event group,the difference was statistically significant(P<0.05).②There was a significant correlation between different levels of non-HDL-C and the incidence of recurrent cardiovascular events with a correlation coefficient of 0.339;③Longistic regression analysis showed that non-HDL-C was a risk factor for reoccurrence of MACE.Conclusion High levels of non-HDL-C are important factors in the short-term prognosis of STEMI patients after PCI,which may increase the incidence of adverse cardiovascular events.