探讨Non-HDL-C、LP(a)与ACS患者冠脉狭窄程度的关系

To Explore the Relationship between Non-HDL-C and LP(a) and Coronary Stenosis in ACS Patients

目的:探究non-HDL-C、LP(a)与急性冠脉综合征患者冠脉病变严重程度的关系,为急性冠脉综合征患者的调脂策略提供思路。方法:选取2020年10月~2022年10月就诊于大理大学第一附属医院心血管内科诊断急性冠脉综合征并接受急诊冠状动脉造影手术的患者,收集纳入对象的临床资料。结果:冠状动脉极重度狭窄组的LDL-c、TG、TC、non-HDL-C、LP(a)水平较高。LP(a)、吸烟、糖尿病、高血压、non-HDL-C、LDL-c、BMI均为Gensini评分升高的独立危险因素。绘制ROC曲线发现,LP(a)、non-HDL-C预测冠状动脉重度狭窄的最佳截断值分别为21.25 mmol/l、3.645 mmol/l。结论:non-HDL-C、LP(a)是ACS患者冠脉狭窄程度的独立预测危险因素,其中LP(a)预测的特异性和敏感性较non-HDL-C强。

Objective: To explore the relationship between non-HDL-C, LP(a) and the severity of coronary artery lesions in patients with acute coronary syndrome, and to provide ideas for the strategy of lipid reg-ulation in patients with acute coronary syndrome. Methods: Patients diagnosed with acute coronary syndrome and receiving emergency coronary angiography were selected from the Department of Cardiovascular Medicine of the First Affiliated Hospital of Dali University from October 2020 to Oc-tober 2022, and clinical data of the included subjects were collected. Results: The levels of LDL-c, TG, TC, non-HDL-C, LP(a) were higher in the extremely severe coronary artery stenosis group. LP(a), smoking, diabetes, hypertension, non-HDL-C, LDL-c and BMI were all independent risk factors for elevated Gensini score. ROC curve showed that the optimal cut-off values of LP(a) and non-HDL-C for predicting severe coronary artery stenosis were 21.25 mmol/l and 3.645 mmol/l, respectively. Conclusion: Non-HDL-C and LP(a) are independent risk factors for predicting the degree of coronary artery stenosis in patients with ACS, and the specificity and sensitivity of LP(a) are stronger than that of non-HDL-C.