摘要
目的观察冠心病(CHD)患者阿托伐他汀治疗后补体C3、补体C4及高密度脂蛋白胆固醇(HDL-C)的水平变化,分析影响患者预后不良的相关因素。方法将100例CHD患者设为CHD组并随机分为阿托伐他汀组与对照组,另选取同期健康体检者100例为健康组。比较各组补体C3、补体C4、HDL-C、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平,分析补体C3、补体C4、HDL-C诊断CHD的效能;采用多因素Logistic回归模型分析预后不良的影响因素。结果CHD组补体C3、补体C4水平高于健康组,HDL-C水平低于健康组,差异均有统计学意义(P<0.05)。补体C3、补体C4及HDL-C诊断CHD的敏感度均不低于80.00%,特异度均不低于75.00%,曲线下面积(AUC)均大于0.80。阿托伐他汀组总有效率为86.00%,高于对照组的68.00%,差异有统计学意义(P<0.05)。阿托伐他汀组治疗后1个月(T2)、治疗后2个月(T3)的HDL-C高于对照组,IL-6、CRP低于对照组,差异均有统计学意义(P<0.05)。阿托伐他汀组预后不良发生率为20.00%(10/50),低于对照组的34.00%(17/50),差异有统计学意义(P<0.05)。单因素分析结果显示,阿托伐他汀组重度患者预后不良发生率更高,差异有统计学意义(P<0.05)。多因素Logistic回归模型分析显示,病情严重程度为重度是CHD患者阿托伐他汀治疗后预后不良的危险因素(P<0.001)。结论CHD患者补体C3、补体C4水平异常升高,HDL-C水平异常降低;补体C3、补体C4及HDL-C在CHD诊断中均具有较高的敏感度、特异度;CHD患者应用阿托伐他汀治疗可提高疗效及HDL-C水平,降低炎性因子水平与预后不良的发生风险,而病情严重程度是CHD患者阿托伐他汀治疗后发生预后不良的独立影响因素。
Objective To observe the changes of complement C3,C4 and high-density lipoprotein cholesterol(HDL-C)levels in patients with coronary heart disease(CHD)after atorvastatin treatment and analyze the related factors affecting the poor prognosis of patients.Methods A total of 100 patients with CHD were selected as CHD group and randomly divided into atorvastatin group and control group,and another 100 healthy people in the same period were selected as healthy group.The levels of complement C3,C4,HDL-C,interleukin-6(IL-6)and C reactive protein(CRP)were compared among three groups,and the efficiency of complement C3,C4 and HDL-C in diagnosing CHD was analyzed;the multivariate Logistic regression model was used to analyze the influencing factors of poor prognosis.Results The levels of complement C3 and C4 in the CHD group were significantly higher than those in the healthy group,while the level of HDL-C was significantly lower than that in the healthy group(P<0.05).The sensitivity and specificity of complement C3,C4 and HDL-C in the diagnosis of CHD were not lower than 80.00%and 75.00%respectively,and the area under the curve(AUC)was greater than 0.80.The total effective rate of the atorvastatin group was 86.00%,which was significantly higher than 68.00%of control group(P<0.05).Levels of HDL-C at 1 month after treatment(T2)and 2 months after treatment(T3)in the atorvastatin group were significantly higher than that in the control group,while levels of IL-6 and CRP were significantly lower than those in the control group(P<0.05).The incidence of poor prognosis in the atorvastatin group was 20.00%(10/50),which was significantly lower than 34.00%(17/50)in the control group(P<0.05).Univariate analysis showed that the incidence of poor prognosis was significantly higher in severe patients in the atorvastatin group(P<0.05).Multivariate Logistic regression model analysis showed that severe status of disease severity was a risk factor for poor prognosis of CHD patients after atorvastatin treatment(P<0.001).Conclusion The levels of complement C3 and C4 in the CHD patients increase abnormally,while HDL-C level decreases abnormally;complement C3,C4 and HDL-C have high sensitivity and specificity in the diagnosis of CHD;atorvastatin treatment for CHD patients can improve the efficacy and HDL-C level,reduce the risks of inflammatory factors and poor prognosis,and the severity of the disease is an independent influencing factor for poor prognosis of CHD patients after atorvastatin treatment.
作者
孙孟雄
杨帅
支雄丽
岳燕君
SUN Mengxiong;YANG Shuai;ZHI Xiongli;YUE Yanjun(Department of Laboratory,Zhangjiakou City First Hospital of Hebei Province,Zhangjiakou,Hebei,075000)
出处
《实用临床医药杂志》
CAS
2022年第24期71-75,共5页
Journal of Clinical Medicine in Practice
基金
河北省医学科学研究课题计划(20221893)。
关键词
冠心病
补体
高密度脂蛋白胆固醇
阿托伐他汀
预后不良
影响因素
coronary heart disease
complements
high-density lipoprotein cholesterol
atorvastatin
poor prognosis
influencing factors
