【摘要】 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。更多还原

【Abstract】 Objective:To investigate the prognostic value of non high density lipoprotein cholesterol(non-HDL-C) for the occurrence of cardiovascular events in patients with acute coronary syndrome(ACS). Method:This study enrolled 324 cases with ACS from 2008 to 2010,and followed up 18 months.Cardiovascular events in this study included primary(all-cause mortality,nonfatal myocardial infarction and nonfatal stroke) and secondary(class Ⅳ heart failure and revascularization treatment) end-point events.The association between baseline non-HDL-C level and the risk of primary and secondary end-point events was analyzed by multivariable logistic regression. Result:①The baseline level of non-HDL-C of patients with primary end-point events was higher(3.75±1.12 mmol/L) than that in patients without the events(3.07±0.69 mmol/L,P<0.05).②Multivariate logistic regression analysis showed that high level of non-HDL-C at baseline was a key predictor of primary end-point events(OR 2.996,95%CI 1.269-7.072,P=0.012) and all-cause mortality(OR 2.983,95%CI 1.189-7.482,P=0.020),but no prognostic value for the occurrence of secondary end point events. Conclusion:Baseline level of non-HDL-C has a prognostic value of primary end-point events and all-cause mortality,and plays an important clinical target for monitoring ACS prognosis and guiding lipid management.更多还原