摘要
目的:探讨外周血单核细胞/高密度脂蛋白胆固醇比值(MHR)在非ST段抬高型心肌梗死(NSTEMI)冠脉病变严重程度及预后评估中的价值。方法:纳入行经皮冠脉介入(PCI)治疗的NSTEMI患者473例,收集临床资料并根据血常规和生化检查结果计算MHR值,随访记录主要不良心脑血管事件(MACCE)发生情况。统计分析外周血MHR水平与患者冠脉病变严重程度的相关性,探索MHR对患者发生MACCE的预测价值。结果:共453例NSTEMI患者完成随访,平均随访(32±15)个月;MHR水平与NSTEMI患者SYNTAX评分呈正相关(r=0.608,P<0.01);年龄(HR=2.895,95%CI:1.086~7.715)、高血压病(HR=1.107,95%CI:1.006~1.219)、2型糖尿病(HR=1.163,95%CI:1.022~1.324)、LDL-C(HR=1.209,95%CI:1.026~1.425)、MHR(HR=2.765,95%CI:1.249~6.122)是NSTEMI患者MACCE的独立预测因素(P<0.05);Kaplan-Meier生存曲线示,高MHR患者MACCE发生率显著高于低MHR患者(Log Rank=15.136,P<0.01);MHR预测MACCE的受试者工作特征曲线下面积为0.742(95%CI:0.686~0.797),最佳诊断临界值为3.45,敏感度为75.25%,特异度为77.58%。结论:外周血MHR水平与NSTEMI患者冠脉病变严重程度正相关,且在辅助预测此类患者发生MACCE方面临床应用价值较高。
Objective:This study aimed to investigate the correlation between monocyte/high-density lipoprotein cholesterol ratio(MHR)and coronary artery lesion severity and prognosis in patients with non-ST-segment elevation myocardial infarction(NSTEMI).Method:A total of 473 patients with NSTEMI who underwent percutaneous coronary intervention(PCI)were enrolled and their major adverse cerebral cardiovascular events(MACCE)were recorded.Pearson correlation analysis was used to analyze the correlation between MHR and Syntax scores in patients with NSTEMI.COX proportional hazard regression model was used to analyze the independent predictors of MACCE in patients with NSTEMI.Kaplan-Meier curves were used to compare the MACCE rates between low-MHR patients and high-MHR patients.ROC curve was employed to investigate the efficacy of MHR in MACCE prediction.Result:A total of 453 patients with NSTEMI completed follow-up.The average follow-up time was(32±15)month.MHR level was positively correlated with Syntax score(r=0.608,P<0.01).Multivariate COX regression analysis demonstrated that age(HR=2.895,95%CI:1.086-7.715),hypertension(HR=1.107,95%CI:1.006-1.219),type 2 diabetes(HR=1.163,95%CI:1.022-1.324),LDL-C(HR=1.209,95%CI:1.026-1.425),MHR(HR=2.765,95%CI:1.249-6.122)were independent predictors of MACCE in patients with NSTEMI.Kaplan-Meier curves showed that the MACCE rate of high-MHR patients was significantly higher than that of low-MHR patients(Log Rank=15.136,P<0.01).ROC curve exhibited that the area under the curve was 0.742(95%CI:0.686-0.797)for MHR predicting MACCE with an cut-off value of 3.45,a sensitivity of 75.25%,a specificity of 77.58%.Conclusion:The level of MHR was positively correlated with the coronary artery lesion severity and could be used for predicting the poor prognosis in patients underwent PCI with NSTEMI.
作者
李莉
李阳
樊泽元
LI Li;LI Yang;FAN Zeyuan(Department of Cardiology,Civil Aviation General Hospital,Beijing,100123,China)
出处
《临床急诊杂志》
CAS
2020年第1期59-64,69,共7页
Journal of Clinical Emergency
关键词
单核细胞
高密度脂蛋白胆固醇
非ST段抬高型心肌梗死
经皮冠脉介入治疗
预后
monocyte
high-density lipoprotein cholesterol
non-ST-segment elevation myocardial infarction
percutaneous coronary intervention
prognosis
作者简介
通信作者:樊泽元,E-mail:fanzy_mhzyy@163.com
