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目的:探讨非高密度脂蛋白胆固醇(non-HDL-C)对急性冠状动脉综合征(ACS)患者事件的预测价值。方法:对2008-2010年期间324例出院的ACS患者进行随访,通过多元Logistic回归方法分析血清基线non-HDL-C水平对随访期间初级终点事件(全因死亡、非致死性心肌梗死及卒中)及次级终点事件(Ⅳ级心功能衰竭和再血管化治疗)的相关性。结果:①初级终点事件组患者血清non-HDL-C水平高于未发生事件组患者[(3.75±1.12)mmol/L∶(3.07±0.69)mmol/L,P<0.05]。②多因素Logistic回归分析发现,血清基线non-HDL-C对初级终点(OR值2.996,95%CI1.269～7.072,P=0.012)和全因死亡(OR值2.983,95%CI 1.189～7.482,P=0.020)的发生有预测价值,但对次级终点事件的发生无预测价值。结论:血清non-HDL-C对ACS患者初级终点事件及全因死亡的发生有预测价值,可以作为监测ACS预后及指导调脂治疗的重要临床指标。
Objective: To investigate the predictive value of non-HDL-C in patients with acute coronary syndrome (ACS). METHODS: A total of 324 patients with discharged ACS were followed up during 2008-2010. Multivariate logistic regression analysis was used to analyze the effect of baseline serum non-HDL-C on primary endpoint events (all-cause mortality, non-fatal myocardial infarction and stroke) And secondary end point events (grade IV heart failure and revascularization). Results: ① The level of serum non-HDL-C in the primary endpoint group was significantly higher than that in the non-event group (3.75 ± 1.12 mmol / L vs 3.07 ± 0.69 mmol / L, P <0.05). (2) Multivariate logistic regression analysis showed that serum non-HDL-C had no significant effect on the primary end point (OR 2.96, 95% CI 1.269-7.072, P = 0.012) and all-cause mortality (OR 2.983, 95% CI 1.189-7.482 , P = 0.020) had predictive value, but no predictive value for the occurrence of secondary end point. Conclusion: Serum non-HDL-C has predictive value for primary endpoint events and all-cause mortality in patients with ACS, which can be used as an important clinical indicator to monitor the prognosis of ACS and guide the treatment of lipid-lowering therapy.