溶血磷脂酸对于评估不稳定心绞痛患者不良预后的临床意义

目的：探讨溶血磷脂酸（ LPA）对于不稳定心绞痛（ UA）患者不良预后的临床意义。方法纳入该院心血管内科于2012年7月1日至2013年7月1日期间收治尚处于UA阶段的非ST段抬高型急性冠状动脉综合征（ NSTE-ACS）患者，收集相关危险因素的临床资料，并进行随访以确认预后转归。分析不同预后各项指标的差异性，并评判敏感指标的预后相关性。结果与未转归至NSTEMI（ UA组）相比，NSTEMI组患者的LPA等12项危险因素存在显著差异，经多因素Logistic回归分析得出年龄（ Age）、心肌梗死溶栓试验危险评分（ TIMI）、低密度脂蛋白胆固醇（ LDL-C）、脂联素（ APN）、LPA这5项指标是UA预后转归为NSTEMI的独立、敏感影响因素。其中LPA用于判定UA不良预后的AUC为0．731，联合其余4项指标判定UA不良预后的AUC为0．831，加入LPA后AUC增加至0．854。结论 LPA水平可作为评判UA预后的独立敏感因素，其含量变化对于UA进展至NSTEMI息息相关，将LPA纳入UA的诊疗体系以用于干预高危风险患者具有重要临床意义。

The clinical significance of the poor prognosis of lysophosphatidic acid on the assessment of patients with unstable angina

Objective To investigate the clinical significance of the poor prognosis of lysophosphatidic acid( LPA) on the assessment of patients with unstable angina(UA).Methods Inclusion of cardiovascular medicine at the hospital between July 1,2012 to 2013,the date of July 1 is still in the UA stage treated non-ST segment elevation acute coronary syndrome ( NSTE-ACS) patients,collect relevant risk factors clinical data and follow-up to confirm the prognostic outcome.Analysis of different prognostic indicators differences, and judge a sensitive indicator of prognostic.Results Compared with no outcome to NSTEMI ( UA group) ,there is a 12 LPA and other risk factors in patients with NSTEMI group,significant differences Multivariate Logistic regression analysis age ( Age) ,Thrombolysis in Myo-cardial Infarction risk score test ( TIMI) ,low-density lipoprotein cholesterol ( LDL-C) ,adiponectin ( APN) ,LPA which five indicators are outcome as an independent prognostic UA,NSTEMI of sensitive factors.Which LPA poor prognosis for determining UA AUC 0.731, the remaining four indicators jointly determine UA poor prognosis for 0.831 AUC increased to 0.854 after adding LPA AUC.Conclu-sions LPA levels can be used as an independent prognostic evaluation UA sensitive factor,its content in progress for UA NSTEMI is closely related to the LPA included in the UA system for diagnosis and treatment of patients at high risk for intervention has important clinical significance.