血清sdLDL-C水平与冠心病PCI手术患者预后的关系

目的探讨血清小而密低密度脂蛋白胆固醇(sdLDL-C)与冠心病经皮冠状动脉介入治疗(PCI)手术患者预后的关系。方法选取2015年5月至2019年12月在该院接受PCI手术的冠心病患者195例。采用全自动生化分析仪检测患者血清sdLDL-C水平,根据血清sdLDL-C水平分为3组:<1.35 mmol/L为A组,1.35~<3.00 mmol/L为B组,≥3.00 mmol/L为C组,每组65例。分析sdLDL-C水平与血管狭窄程度的关系。术后随访6个月,观察不良心脏事件发生情况。采用Logistic回归分析冠心病PCI手术患者发生不良心脏事件的危险因素。结果3组在糖尿病史、高血压史方面比较,差异有统计学意义(P<0.05)。C组术前血清sdLDL-C、TG、LDL-C水平,Gemini评分和不良心脏事件发生率明显高于B组和A组,且B组明显高于A组(P<0.05)。相关性分析显示,血清sdLDL-C水平与Gemini评分呈正相关(r=0.582,P=0.003)。Logistic回归分析发现:年龄≥60岁、糖尿病史、高血压史、血清sdLDL-C为1.35~<3.00 mmol/L和血清sdLDL-C≥3.00 mmol/L为冠心病PCI手术患者术后发生不良心脏事件的独立危险因素(P<0.05)。结论血清sdLDL-C水平与冠心病PCI手术患者血管病变程度呈正相关,其高表达为冠心病PCI手术患者术后发生不良心脏事件的独立危险因素,血清sdLDL-C有望成为冠心病患者PCI术后预后评价的生物标志物。

Relationship between serum sdLDL-C level and prognosis in operative patients with coronary heart disease undergoing PCI

Objective To investigate the relationship between serum small dense low-density lipoprotein cholesterol(sdLDL-C)and the prognosis in the operative patients of coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).Methods One hundred and ninety-five patients with CHD receiving PCI in this hospital from May 2015 to December 2019 were selected.The serum sdLDL-C level was measured by adopting the fully automatic biochemical analyzer.According to the serum sdLDL-C level,the patients were divided into the three groups,sdLDL-C<1.35 mmol/L served as the group A,1.35 mmol/L≤sdLDL-C<3.00 mmol/L as the group B and sdLDL-C≥3.00 mmol/L as the group C,65 cases in each group.The relationship between the sdLDL-C level and the vascular stenosis degree was analyzed.The postoperative 6-month follow-up was performed.The occurrence situation of adverse cardiac events was observed.The Logistic regression was adopted to analyze the influencing factors of adverse cardiovascular events occurrence in the patients with CHD undergoing PCI.Results The three groups had the statistical difference in the aspects of the diabetic history and hypertension history(P<0.05).The preoperative serum sdLDL-C,TG and LDL-C levels,Gemini score and incidence rate of adverse cardiac events in the group C were significantly higher than those in the group B and A,moreover the group B was significantly higher than the group A(P<0.05).The correlation analysis showed that the serum sdLDL-C level was positively correlated with the Gemini score(r=0.582,P=0.003).The Logistic regression analysis showed that the age≥60 years old,diabetic history,hypertension history,serum sdLDL-C 1.35-<3.00 mmol/L and serum sdLDL-C≥3.00 mmol/L were the independent risk factors of adverse cardiac events occurrence after PCI in the patients with CHD(P<0.05).Conclusion Serum sdLDL-C has a positive correlation with the vascular lesion degree in the CHD patients with PCI.The high expression of sdLDL-C is an independent risk factor for adverse cardiac events occurrence after PCI in the patients with CHD.Serum sdLDL-C is expected to be a biomarker for the evaluation of the prognosis in the patients with CHD after PCI.