UA、TG、LDL-C、Plip对冠心病二级预防降脂治疗患者的危险因素研究

A Study of Risk Factors of UA,TG,LDL-C and Plip in CHD Patients with Secondary Prevention Lipid-Lowering Therapy

目的回顾性分析冠心病患者二级预防降脂治疗后相关检测指标的变化趋势,并探讨其潜在危险因素。方法研究我院收治的冠心病患者病例资料并及时收集其清晨首次血清样本,用于相关血液学指标测定。结果与对照组相比,疾病组在性别和年龄上差异无统计学意义(P>0.05),尿素(urea,UREA)、尿酸(uric acid,UA)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density liptein cholesterol,LDL-C)、总胆固醇(total cholesterol,CHOL)、三酰甘油(triglyceride,TG)、唾液酸(sialic acid,SA)、超氧化物歧化酶(super oxide dismutase,SOD)、磷脂(phospholipid,Plip)、小而密低密度脂蛋白(small dense low density lipoprotein,sdLDL-C)等10项血液学指标差异具有统计学意义(P<0.05);经二元Logistic回归分析,Groups(UREA+UA+HDL-C+LDL-C+CHOL+TG+SA+SOD+Plip+sdLDL-C)诊断效能为87.2%,ROC曲线下面积为0.940,灵敏度90.7%,特异性80.2%,UA、TG、LDL-C、Plip为冠心病启动二级预防降脂治疗的危险因素,OR(95%CI)分别为1.01(1.006~1.013)、5.292(2.643~10.596)、6.159(1.151~32.948)、119.569(23.611~605.52)。结论血液指标Groups联合监测对于冠心病启动二级预防降脂治疗具有较高的诊断效能,UA、TG、LDL-C、Plip为冠心病启动二级预防降脂治疗过程中潜在的危险因素,需结合临床,加强针对性干预,进一步提高预后疗效。

Objective To explore potential risk factors by a retrospective analysis of the changes of related indicators in patients with coronary heart disease(CHD)after secondary prevention lipid-lowering treatment.Methods We studied the clinical data of CHD patients in our hospital and collected the fasting serum samples in the morning for the determination of related hematological indexes.Results Compared with the control group,there was no significant difference in sex and age(P>0.05),while there were significant differences in UREA,UA,HDL-C,LDL-C,CHOL,TG,SA,SOD,Plip,and sdLDL-C(P<0.05)in the observation group.The study group(UREA+UA+HDL-C+LDL-C+CHOL+TG+SA+SOD+Plip+sdLDL-C)was selected in logistic regression equation established.Its diagnostic efficiency was 87.2%(AUC=0.940,sensitivity=90.7%,specificity=80.2%).UA,TG,LDL-C,Plip were risk factors of secondary prevention of CHD,with OR(95%CI)of 1.01(1.006-1.013),5.292(2.643-10.596),6.159(1.151-32.948),119.569(23.611-605.52),respectively.Conclusion The combination of above indexes has a higher diagnostic efficacy in CHD patients with secondary prevention lipid-lowering treatment.UA,TG,LDL-C and PLIP are risk factors for secondary prevention of CHD.Clinical intervention treatment should be strengthened in order to improve the prognosis.