脂蛋白a与急性心肌梗死患者冠脉侧支循环形成的关系分析

Analysis of the relationship between lipoprotein a and coronary collateral circulation in patients with acute myocardial infarction

目的:分析脂蛋白a与急性心肌梗死患者冠脉侧支循环形成的关系。方法:选取保定市第四中心医院2020年1月—2020年12月收治的400例急性心肌梗死患者为研究对象,依据Rentrop分级分为冠脉侧支循环形成不良组(250例)以及冠脉侧支循环形成良好组(150例),测定并比较两组血清脂蛋白a的差异,利用Spreaman相关性分析法检验脂蛋白a与急性心肌梗死患者冠脉侧支循环形成的相关性,绘制受试者工作特征曲线评价脂蛋白a预测急性心肌梗死患者冠脉侧支循环形成的价值。结果:冠脉侧支循环形成不良组血清脂蛋白a、心肌酶谱、肌钙蛋白I、脑钠肽高于冠脉侧支循环形成良好组,差异有统计学意义(P<0.05);Spreaman相关性分析结果提示:脂蛋白a与急性心肌梗死患者Rentrop分级呈负相关性(r=-0.52,P<0.05),心肌酶谱、肌钙蛋白I、脑钠肽与急性心肌梗死患者Rentrop分级无相关性(P>0.05);受试者工作特征曲线提示:脂蛋白a预测急性心肌梗死患者冠脉侧支循环形成的曲线下面积为0.910、截断值为170.50mg/L、敏感度为88.8%、特异度为96.4%。结论:脂蛋白a与急性心肌梗死患者冠脉侧支循环形成密切相关且可作为预测指标推广使用。

Objective:To analyze the relationship between lipoprotein a and coronary collateral circulation in patients with acute myocardial infarction.Methods:A total of 400patients with acute myocardial infarction who were admitted to Baoding Fourth Central Hospital from January 2020to December 2020were selected as the research objects.According to the Rentrop classification,they were divided into the poor coronary collateral circulation group(250cases)and the good coronary collaterals circulation group(150cases).The difference of serum lipoprotein a between the two groups was measured and compared.The spreaman correlation analysis method was used to test the correlation between lipoprotein a and the formation of coronary collateral circulation in patients with acute myocardial infarction,and the value of lipoprotein a in predicting the formation of coronary collateral circulation in patients with acute myocardial infarction was evaluated by drawing the receiver operating characteristic curve.Results:The levels of serum lipoprotein a,myocardial enzymes,troponin I,and brain natriuretic peptide in the poor coronary collateral circulation group were higher than those in the well-formed coronary collateral circulation group,the difference was statistically significant(P<0.05).Spreaman Correlation analysis results indicated that lipoprotein a was negatively correlated with Rentrop grade in patients with acute myocardial infarction(r=-0.52,P<0.05).There was no correlation between myocardial enzyme spectrum,troponin I and brain natriuretic peptide in patients with acute myocardial infarction(P>0.05).The receiver operating characteristic curve suggested that the area under the curve for lipoprotein a to predict coronary collateral circulation in patients with acute myocardial infarction was 0.910,the cut-off value was 170.50mg/L,the sensitivity was 88.8%,and the specificity was 96.4%.Conclusion:Lipoprotein a is closely related to the formation of coronary collateral circulation in patients with acute myocardial infarction and can be widely used as a predictive indicator.