Non-HDL-C和RLP-C与急性ST段抬高型心肌梗死行急诊PCI住院期间不良心脏事件的相关性研究

The correlation between non-HDL-C and RLP-C and acute ST-segment elevation myocardial infarction and adverse cardiac events during hospitalization after emergency PCI

目的 探讨非高密度脂蛋白胆固醇(non-HDL-C)和残粒脂蛋白胆固醇(RLP-C)与急性ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)住院期间发生不良心脏事件的相关性。方法 回顾性选取2017年1月~2018年6月在安徽省立医院就诊并接受急诊PCI手术的STEMI患者400例(入院前1个月内均无他汀类药物的持续服用史),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(32例)和良好组(368例)。对所有患者进行血脂检测,并计算其non-HDL-C和RLP-C值。比较MACE组与良好组之间的non-HDL-C和RLP-C值差异,并通过多因素logistic回归分析non-HDL-C和RLP-C与STEMI患者行急诊PCI手术住院期间发生MACE的相关性。结果 与良好组相比,MACE组患者的non-HDL-C和RLP-C值均显著升高,差异有统计学意义(P<0.01)。多因素logistic回归分析表明,non-HDL-C和RLP-C值是STEMI患者发生院内MACE的独立预测因素(OR=1.728,1.672;P<0.01)。结论 non-HDL-C和RLP-C水平与STEMI行急诊PCI手术住院期间MACE的发生情况密切相关,积极控制non-HDL-C和RLP-C可能有助于防止急性心肌梗死的发生,检测non-HDL-C和RLP-C值可能有助于STEMI早期风险的评估。

Objective To explore the correlation between non-high density lipoprotein cholesterol(non-HDL-C)and residual lipoprotein cholesterol(RLP-C)and adverse cardiac events during emergency percutaneous coronary intervention operation in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods 400 STEMI patients who received emergency PCI operation from January 2017 to June 2018 were divided into MACE group(n=32)and good group(n=368)according to whether major adverse cardiac events(MACE)occurred during hospitalization,all patients did not continue to take statins within one month before admission.The blood lipids of the above patients were measured and their non-HDL-C and RLP-C values were calculated.The differences of non-HDL-C and RLP-C values between MACE group and good group were compared.The correlation between the above two indexes and the occurrence of MACE in STEMI patients during emergency PCI was verified by multivariate logistic regression analysis.Results Compared with the good group,the values of non-HDL-C and RLP-C in MACE group were significantly higher(P<0.01).Multivariate logistic regression analysis showed that non-HDL-C and RLP-C were independent predictors of nosocomial MACE in STEMI patients(OR=1.728,OR=1.672,P<0.01).Conclusion The levels of non-HDL-C and RLP-C are closely related to the occurrence of MACE during STEMI emergency PCI.Active control of non-HDL-C and RLP-C may help to prevent the occurrence of acute myocardial infarction.Detection of non-HDL-C and RLP-C values may help to assess the early risk of STEMI.