残余脂蛋白胆固醇与慢性完全闭塞性病变患者侧支循坏的相关性分析

The association between remnant-like particle cholesterol and collateral circulation in patients with chronic total occlusion

目的:本研究主要探索残余脂蛋白胆固醇(remnant-like particle cholesterol, RLP-c)与慢性完全闭塞性病变(chronic total occlusion, CTO)患者侧支循环的相关性。方法:本研究主要回顾性纳入549例CTO患者,依据rentrop分级系统将纳入人群分为两组,即侧支循环充分组(rentrop 2-3级)412例与侧支循环不充分组(rentrop 0-1级)137例。通过多因素回归分析探索RLP-c与侧支循环的相关性。结果:本研究共纳入549例CTO患者,其中侧支循环不充分组137例。与侧支循环充分组相比,侧支循环不充分组RLP-c浓度较高[0.7(0.4, 1.0)vs. 0.5(0.4, 0.7),P<0.001]。不仅在单因素回归分析中,RLP-c与侧支循环形成不良紧密相关(OR=4.658,95%CI:2.731~7.945,P<0.001),通过多因素回归分析校正其他混杂因素影响后,RLP-c仍是侧支循环形成不良的独立危险因素(OR=4.944,95%CI:2.828~8.645,P <0.001)。进一步依据3分位数将RLP-c调整成分类变量后,上述关系仍成立。最后受试者工作特征曲线进一步证实RLP-c可有效预测侧支循环形不充分的发生(曲线下面积0.664,95%CI:0.613~0.716,P <0.001)。结论:独立于传统血脂参数,RLP-c与CTO患者侧支循环形不充分独立相关。

Objective:This study mainly explores the correlation between RLP-c and collateral circulation in patients with chronic total occlusion(CTO).Methods:This study retrospectively enrolled 549 CTO patients and divided the population into two groups according to the rentrop grading system,namely the good collateral circulation group(rentrop 2-3 level)and the poor collateral circulation group(rentrop 0-1 level).Exploring the correlation between RLP-c and collateral circulation through multivariate regression analysis.Results:A total of 549 CTO patients were included in this study,including 137 in the group with poor collateral circulation.Compared with the group with good collateral circulation,the group with poor collateral circulation had a higher concentration of[0.7(0.4,1.0)vs.0.5(0.4,0.7),P<0.001].Not only was RLP-c closely associated with poor collateral circulation formation in univariate regression analysis(OR=4.658,95%CI:2.731-7.945,P<0.001),but after adjusting for other confounding factors through multivariate regression analysis,RLP-c remained an independent risk factor for poor collateral circulation formation(OR=4.944,95%CI:2.828-8.645,P<0.001).After further adjusting RLP-c to a categorical variable based on the tertile of RLP-c,the above relationship still persisted.Finally,the Receiver operating characteristics curve further confirmed that RLP-c can effectively predict the occurrence of the poor collateral circulation(area under the curve 0.664,95%CI:0.613-0.716,P<0.001).Conclusions:Independent of traditional lipid parameters,RLP-c is independently associated with the poor collateral circulation in CTO patients.