血清淀粉样蛋白A1、脂蛋白结合指数预测急性冠脉综合征患者病情严重程度及预后的价值

The Analysis of Value for Serum Amyloid A1 and Lipoprotein Binding Index in Predicting the Severity and Prognosis of Patients with Acute Coronary Syndrome

目的探讨血清淀粉样蛋白A1(SAA1)、脂蛋白结合指数(LCI)对急性冠脉综合征(ACS)患者病情严重程度及预后的评估价值。方法选取2016年12月至2019年1月我科收治的130例ACS患者作为研究对象(观察组),同时,另选我院体检健康志愿者80例(对照组)。比较各组受试者血清SAA1、LCI水平。根据患者出院后6个月是否发生不良心血管事件(MACE)分为预后良好组和预后不良组。采用COX比例风险模型分析影响ACS患者预后的危险因素,采用受试者工作特征曲线(ROC)分析SAA1、LCI对ACS患者短期预后的评估价值。结果观察组血清SAA1、LCI水平高于对照组,差异有统计学意义(P<0.05)。ACS重度组血清SAA1、LCI水平高于中度组、轻度组,中度组血清SAA1、LCI水平高于轻度组,差异有统计学意义(P<0.05)。预后不良组患者血清SAA1、LCI水平高于预后良好组患者,差异有统计学意义(P<0.05)。COX多因素回归分析结果显示,Genisis评分、SAA1、LCI是影响ACS患者预后的独立危险因素(P<0.05)。ROC曲线显示,SAA1、LCI预测ACS患者短期预后的曲线下面积分别为0.821、0.840。结论ACS患者血清SAA1、LCI水平明显升高,与患者病情严重程度及短期预后密切相关,且对ACS患者预后评估有一定预测价值。

Objective To explore the evaluation value of serum amyloid A1(SAA1)and lipoprotein combine index(LCI)on the severity and prognosis of patients with acute coronary syndrome(ACS).Methods 130 ACS patients admitted to our department from December,2016 to January,2019 were selected as the research objects(the observation group),while another 80 healthy volunteers(the control group)were selected from physical examination in our hospital.We then compared the serum SAA1 and LCI levels of patients in each group.According to whether the patients had an adverse cardiovascular event(MACE)6 months after discharge,they were also divided into the good prognosis group and poor prognosis group.The COX proportional hazards model was applied to analyze the risk factors affecting the prognosis of ACS patients.The receiver operating characteristic curve(ROC)was drawn to analyze the evaluation value of SAA1 and LCI for the short-term prognosis of ACS patients.Results The serum SAA1 and LCI levels in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of serum SAA1 and LCI in the severe group of ACS were higher than those in the moderate group and the mild group,and the levels of serum SAA1 and LCI in the moderate group were higher than those in the mild group.The difference was statistically significant(P<0.05).The serum SAA1 and LCI levels of patients in the poor prognosis group were higher than those in the good prognosis group,and the difference was statistically significant(P<0.05).COX multivariate regression analysis showed that Genisis score,SAA1 and LCI levels were independent risk factors affecting the prognosis of ACS patients(P<0.05).ROC curve showed results as following:SAA1 and LCI could predict the short-term prognosis of ACS patients with areas under the curve of 0.821 and 0.840,respectively.Conclusion Serum SAA1 and LCI levels in ACS patients are significantly increased,which are closely related to the severity of the patient’s condition and short-term prognosis,and have a certain predictive value for the prognosis of ACS patients.