作者：孟杰杰，孙亚召，白春兰，许新新，孙培

单位：

061000河北省沧州市人民医院心内科

Units：

Department of Cardiology, Cangzhou People's Hospital, Cangzhou 061000, China

关键词：

心肌梗死；经皮冠状动脉介入治疗；残余胆固醇；主要不良心血管事件

Keywords：

Myocardial infarction; Percutaneous coronary intervention; Residual cholesterol; Major adverse cardiovascular events

CLC：

R 542.22

DOI：

10.12114/j.issn.1008-5971.2024.00.004

Funds：

河北省医学科学研究课题计划项目（20211161）

摘要：

目的　探讨残余胆固醇与老年急性心肌梗死（AMI）患者PCI后主要不良心血管事件（MACE）的关 系。方法　回顾性选取2018年12月—2021年12月在沧州市人民医院住院并行PCI的老年AMI患者205例为研究对象。收 集患者的临床资料，术后随访12个月，记录患者MACE发生情况。采用多因素Logistic回归分析探讨老年AMI患者PCI 后发生MACE的影响因素；采用ROC曲线分析残余胆固醇对老年AMI患者PCI后发生MACE的预测价值。结果　205例 老年AMI患者PCI后发生MACE 48例（23.4%），发生MACE者总胆固醇（TC）、三酰甘油（TG）、残余胆固醇高于未 发生MACE者（P＜0.05）。多因素Logistic回归分析结果显示，TG〔OR=3.707，95%CI（1.988～6.912）〕、残余胆固 醇〔OR=4.707，95%CI（1.406～15.762）〕是老年AMI患者PCI后发生MACE的独立影响因素（P＜0.05）。ROC曲线分 析结果显示，残余胆固醇预测老年AMI患者PCI后发生MACE的曲线下面积为0.767〔95%CI（0.695～0.839）〕，最佳 截断值为0.74 mmol/L，灵敏度为77.1%，特异度为77.0%。结论　TG、残余胆固醇是老年AMI患者PCI后发生MACE的独 立影响因素，且残余胆固醇对老年AMI患者PCI后发生MACE有一定预测价值。

Abstract：

Objective To explore the correlation of residual cholesterol with major adverse cardiovascular events (MACE) after PCI in elderly patients with acute myocardial infarction (AMI) . Methods A retrospective study was conducted on 205 elderly patients with AMI who underwent PCI in Cangzhou People's Hospital from December 2018 to December 2021. The clinical data of the patients were collected, the patients were followed up for 12 months and MACE were recorded. Multivariate Logistic regression analysis was used to explore the influencing factors of MACE after PCI in elderly patients with AMI. The ROC curve was used to explore the predictive value of residual cholesterol for MACE after PCI in elderly patients with AMI. Results Among 205 elderly patients with AMI after PCI, 48 (23.4%) had MACE. Total cholesterol (TC) , triglyceride (TG) and residual cholesterol in MACE patients were higher than those in non-MACE patients (P < 0.05) . Multivariate Logistic regression analysis showed that TG [OR=3.707, 95%CI (1.988-6.912) ] , residual cholesterol [OR=4.707, 95%CI (1.406-15.762) ] were the independent influencing factors of MACE after PCI in elderly patients with AMI (P < 0.05) . ROC curve analysis showed that the AUC of the residual cholesterol in predicting MACE after PCI in elderly patients with AMI was 0.767 [95 %CI (0.695-0.839) ] , the optimal cut-off value was 0.74 mmol/L, the sensitivity was 77.1%, and the specificity was 77.0%. Conclusion TG, residual cholesterol are the independent influencing factors of MACE after PCI in elderly patients with AMI. Residual cholesterol have certain value in the prediction of MACE after PCI in elderly patients with AMI.

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