摘要
目的:探讨小而低密度脂蛋白(sdLDL)与冠心病患者经皮冠状动脉介入治疗(PCI)术后围手术期心肌损伤(PMI)的相关性。方法:纳入2021-01—2022-04黄梅县中医医院收治的行PCI手术的冠心病患者237例,依据PCI术后24h内的心肌损伤情况分为PMI组(69例)和非PMI组(168例)。全自动生化分析仪检测术前血糖(Glu)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和sdLDL水平;使用全自动化学发光分析仪检测术前和术后24h血清心肌肌钙蛋白I(cTnI)水平。单因素和多因素Logistic回归分析探讨sdLDL水平与PMI的相关性;ROC曲线分析sdLDL对PMI的预测价值。结果:PMI组患者TG、LDL及sdLDL水平较非PMI组升高,HDL水平较非PMI组降低(P<0.05)。Logsitic回归分析显示患者术前sdLDL水平与PMI显著相关。sdLDL预测PMI的ROC曲线下面积及其95%CI为0.708(0.638-0.779)。结论:术前高水平的sdLDL水平是冠心病患者PCI术后PMI的潜在危险因素,术前检测sdLDL水平对PMI有一定的预测价值。
Objective:To investigate the correlation between small and low density lipoprotein(sdLDL)and perioperative myocardial injury(PMI)in patients with coronary heart disease after PCI.Method:From January 2021 to April 2022,237 patients with coronary heart disease who underwent PCI were included.According to the myocardial injury within 24 hours after PCI,they were divided into PMI group(69 cases)and non-PMI group(168 cases).Automatic biochemical analyzer was used to detect the levels of preoperative blood glucose(Glu),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)and small and low density lipoprotein(sdLDL).Serum cTnI levels were detected using an ACS180 automatic chemiluminescence analyzer.Single factor and multi factor logistic regression analysis were used to explore the correlation between sdLDL and PMI.The diagnostic value of sdLDL for PMI was analyzed by ROC curve.Results:The levels of TG,LDL and sdLDL in the PMI group were higher than those in the non-PMI group,and the HDL level was lower,and the difference between the two groups was statistically significant(P<0.05).Logsitic regression analysis found that there was a significant correlation between preoperative sdLDL level and PMI.The area under the ROC curve and its 95%CI of sdLDL for diagnosing PMI was 0.708(0.638-0.779).Conclusion:The high level of sdLDL before PCI is a potential risk factor for perioperative myocardial injury in patients, and the detection of sdLDL has a certain predictive value for PMI.
作者
黄记兵
张巧琼
HUANG Ji-bing;ZHANG Qiao-qiong(Department of Clinical Laboratory,Huangmei County Hospital of Traditional Chinese Medicine,Huangmei 435500,China)
出处
《微循环学杂志》
2022年第4期58-61,65,共5页
Chinese Journal of Microcirculation
关键词
冠心病
经皮冠状动脉介入治疗术
围手术期心肌损伤
小而低密度脂蛋白
Coronary heart disease
Percutaneous coronary intervention
Perioperative myocardial injury
Small and low-density lipoprotein
