冠心病患者血清脂蛋白a、同型半胱氨酸及低密度脂蛋白水平与不良心脑血管事件的相关性分析

目的探究冠心病患者血清脂蛋白aLp(a)]、同型半胱氨酸(Hcy)及低密度脂蛋白(LDL)水平与不良心脑血管事件的相关性。方法回顾性分析2017年1月至2018年6月期间到我院就诊149例冠心病患者相关资料,分析随访期间患者不良心脑血管事件发生情况,依据随访期间是否出现不良心脑血管事件分为研究组与对照组,比较两组患者Lp(a)、Hcy以及LDL水平,三指标水平对不良心脑血管事件诊断价值,对三指标之间相关性进行分析。结果随访期间患者不良心脑血管事件发生率为10.07%(15/149);研究组患者血清中Lp(a)、Hcy以及LDL水平显著高于对照组(P<0.05);ROC曲线显示Lp(a)、Hcy以及LDL对不良心脑血管事件诊断最佳截断值分别为180mg/L、15μmol/L以及3.78mmoL/L,,其诊断灵敏度分别为73.27%、84.35%与81.29%,其诊断特异性分别为79.35%、81.34%以及80.24%;Pearson相关性分析显示Lp(a)与Hcy之间关系为正相关(r=0.371,P<0.05),Hcy与LDL之间为负相关(r=-0.513,P<0.05),Lp(a)与LDL之间没有相关性(r=0.068,P>0.05)。结论冠心病患者血清中Lp(a)、Hcy以及LDL水平异常升高状态会增加患者不良心脑血管事件发生风险。

The Correlation Between Levels of Serum lipoprotein(a),Homocysteine and Low Density Lipoprotein and Adverse Cardiovascular Events in Patients with Coronary Heart Disease

Objective To investigate the correlation between levels of Serum lipoprotein(a)Lp(a)],homocysteine(Hcy)and low density lipoprotein(LDL)and adverse cardiovascular events in patients with coronary heart disease.Methods The relevant clinical data of 149 patients with coronary heart disease who were admitted to the hospital from January,2017 to June,2018 were retrospectively analyzed.The incidence of adverse cardiovascular and cerebrovascular events during the follow-up was investigated.According to whether there were adverse cardiovascular and cerebrovascular events during the follow-up,the patients were divided into the study group and the control group.Levels of Lp(a),Hcy and LDL were compared between the two groups.The diagnostic value of the three indicators for adverse cardiovascular and cerebrovascular events,and the correlation among the three indicators were evaluated.Results The incidence of adverse cardiovascular and cerebrovascular events during the follow-up was 10.07%(15/149).The levels of serum Lp(a),Hcy and LDL in the study group were significantly higher than those in the control group(P<0.05).ROC curve showed that the best cutoff values of Lp(a),Hcy and LDL for the diagnosis of adverse cardiovascular and cerebrovascular events were 180 mg/L,15μmol/L and 3.78 mmoL/L,respectively.The diagnostic sensitivities were 73.27%,84.35%and 81.29%,respectively.The diagnostic specificities were 79.35%,81.34%and 80.24%,respectively.Pearson correlation analysis showed that Lp(a)was positively correlated with Hcy(r=0.371,P<0.05),while Hcy was negatively correlated with LDL(r=-0.513,P<0.05).There was no correlation between Lp(a)and LDL(r=0.068,P>0.05).Conclusion Abnormal increase of levels of Lp(a),Hcy and LDL in patients with coronary heart disease can increase the risk of adverse cardiovascular events.