急性心肌梗死患者血脂水平变化与PCI术后并发症及预后的相关性分析

Analysis of Correlation between Changes of Blood Lipid Level and Complications and Prognosis after PCI in Patients with Acute Myocardial Infarction

【目的】探讨血脂水平与急性心肌梗死(AMI)患者经皮冠脉介入术(PCI)术后并发症及预后的相关性。【方法】选取2014年8月至2016年8月本院收治的150例行PCI米AMI患者的临床资料,根据患者血脂水平将其分为高脂血症组(血脂水平高于正常参考标准,n=80)和非高脂血症组(血脂水平正常,n=70)。记录患者术后并发症发生情况及首次出现的时间,Logistic多因素分析影响患者术后并发症发生的危险因素。采用Spearman相关系数分析血脂指标与并发症发生时间的相关性。【结果】高脂血症组血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平明显高于非高脂血症组,血清高密度脂蛋白胆固醇(HDL-C)水平明显低于非高脂血症组,差异有统计学意义(P<0.05)。高脂血症组术后支架内血栓、再发心肌梗死、靶血管再狭窄、缺血性卒中发生率明显高于非高脂血症组,差异均有统计学意义(P<0.05)。Spearman系数相关性分析,TC、TG、LDL-C与患者并发症发生的时间呈负相关(r=—0.589,-0.677,-0.899,均P<0.05),HDL-C与患者并发症发生时间呈正相关(r=0.869,P<0.05)。以Kaplan-meier法绘制患者无病生存曲线,以log-rank法进行检验,结果显示非高脂血症组预后明显优于高脂血症组(X^2=5.014,P=0.025)。Logistic多因素分析后结果显示,TC、TG为影响AMI患者预后的危险因素(P<0.05)。【结论】行PCI术治疗存在高脂血症的AMI患者较非高脂血症患者术后并发症的发生率更高,并且血脂水平与并发症发生的时间显著相关,其中TC、TG为影响患者预后的危险因素。

【Objective】To explore the correlation between blood lipid level and complications and prognosis of patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).【Methods】The clinical data of 150 patients with AMI undergoing PCI from August 2014 to August 2016 were selected and divided into hyperlipidemia group(hyperlipidemia level higher than normal reference standard,n=80)and non-hyperlipidemia group(normal blood lipid level,n=70).The occurrence of complications and the time of first occurrence were recorded.Logistic multivariate analysis was used to analyze the risk factors affecting the occurrence of complications.Spearman correlation coefficient was used to analyze the correlation between blood lipid index and the time of complications.【Results】Serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)levels in hyperlipidemia group were significantly higher than those in non-hyperlipidemia group,and serum high density lipoprotein cholesterol(HDL-C)levels were significantly lower than those in non-hyperlipidemia group(P<0.05).The incidence of stent thrombosis,recurrent myocardial infarction,target vessel restenosis and ischemic stroke in hyperlipidemia group was significantly higher than that in non-hyperlipidemia group(P<0.05).Spearman coefficient correlation analysis showed that TC?TG and LDL-C were negatively correlated with the time of complications(r=-0.589,-0.677,-0.899,all P<C0.05),while HDL-C was positively correlated with the time of complications(r=0.869,P<0.05).The disease-free survival curve was drawn by Kaplan-meier method and tested by log-rank method.The results showed that the prognosis of non-hyperlipidemia group was significantly better than that of hyperlipidemia group(X^2=5.014,P=0.025).Logistic multivariate analysis showed that TC and TG were risk factors for the prognosis of patients with AMI(P<0.05).【Conclusion】The incidence of complications in AMI patients with hyperlipidemia treated by PCI is higher than that in non-hyperlipidemia patients,and the level of blood lipid is significantly correlated with the time of complications.TC and TG are the risk factors affecting the prognosis of patients.