目的:探讨急性ST段抬高型心肌梗死(STEMI)患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值(LHR)与其院内主要不良心血管事件(MACE)的相关性及其在临床中的应用价值。方法:收集发病12h内就诊的481例STEMI住院患者的临床资...目的:探讨急性ST段抬高型心肌梗死(STEMI)患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值(LHR)与其院内主要不良心血管事件(MACE)的相关性及其在临床中的应用价值。方法:收集发病12h内就诊的481例STEMI住院患者的临床资料及MACE发生情况,根据LHR的中位数(2.9)将患者分为低LHR组(LHR≤2.9,n=223)和高LHR组(LHR>2.9,n=258)。分析LHR与STEMI患者院内MACE的相关性。结果:高LHR组患者院内MACE比例均高于低LHR组[恶性室性心律失常:29(11.2%) VS 9(4.0%),P=0.004;高度房室传导阻滞:22(8.5%) VS 6(2.7%),P=0.006;心源性休克+死亡:29(11.2%) VS 7(3.1%),P=0.001]。恶性室性心律失常、心源性休克+死亡患者LHR差异有统计学意义(P均<0.05)。Pearson相关分析显示,除高度房室传导阻滞(r=0.060,P>0.05)外,LHR与恶性室性心律失常(r=0.121)、心源性休克和死亡(r=0.115)均显著相关(P<0.05)。多因素Logistic回归分析显示,LHR、空腹血糖是STEMI患者发生院内MACE的独立危险因素(P均<0.05)。ROC曲线显示LHR预测STEMI患者院内MACE的曲线下面积为0.606(95%CI:0.544~0.668),cut-off值为2.854,敏感度为80.6%,特异度为52.1%;LHR>2.854时STEMI住院患者很可能会发生MACE。结论:STEMI患者LHR升高与恶性室性心律失常、心源性休克及死亡发生呈正相关。LHR是STEMI患者发生MACE的独立危险因素,对恶性室性心律失常、心源性休克及死亡发生有一定的预测价值。展开更多
Dyslipidemia the major cause of atherosclerosis are suggested to act synergistically with non-lipid risk factors to increase atherogenesis.Low-density lipoprotein cholesterol(LDL-C) is the main therapeutic target in t...Dyslipidemia the major cause of atherosclerosis are suggested to act synergistically with non-lipid risk factors to increase atherogenesis.Low-density lipoprotein cholesterol(LDL-C) is the main therapeutic target in the prevention of CVD.Increased triglycerides(TG) and decreased high-density lipoprotein(LDL-C) are considered to be a major risk factor for the development of insulin resistant and metabolic syndrome.Although the TG/ HDL-C ratio has been used in recent studies as a clinical indicator for insulin resistance,results were inconsistent. The TG/HDL-C ratio is also widely used to assess the lipid atherogenesis.How ever the utility of this rate for predicting coronary heart disease(CHD) risk is not clear.We encountered myocardial infarct patients with normal serum lipid concentration so this study was undertaken to evaluate the usefulness of these lipid ratios in predicting CHD risk in normolipidemic AMI patients and to compare the results with healthy subjects.The aim of the present study was to evaluate serum TC/HDL-C,TG/HDL-C and LDL-C/HDL-C in myocardial infarct subjects with normal lipid profile.To study this,lipid profile was determined in 165 normolipidemic acute myocardial infarction patients and 165 age/sex-matched controls.Total cholesterol,triglycerides,and HDL-cholesterol were analyzed enzymatically using kits obtained from Randox Laboratories Limited,Crumlin,UK. Plasma LDL-cholesterol was determined from the values of total cholesterol and HDL- cholesterol using the friedwalds formula.The values were expressed as means±standard deviation(SD) and data from patients and controls was compared using students t-test.The results and conclusion of the study were:Total cholesterol, TC:HDL-C ratio,triglycerides,LDL-cholesterol,LDL:HDL-C ratio were higher in MI patients(p【0. 001).HDL-C concentration was significantly lower in MI patients than controls(p【0.001).Higher ratio of TC/HDL-C,TG/HDL-C and LDL-C/HDL-C was observed in AMI patients compared to controls.展开更多
文摘目的:探讨急性ST段抬高型心肌梗死(STEMI)患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值(LHR)与其院内主要不良心血管事件(MACE)的相关性及其在临床中的应用价值。方法:收集发病12h内就诊的481例STEMI住院患者的临床资料及MACE发生情况,根据LHR的中位数(2.9)将患者分为低LHR组(LHR≤2.9,n=223)和高LHR组(LHR>2.9,n=258)。分析LHR与STEMI患者院内MACE的相关性。结果:高LHR组患者院内MACE比例均高于低LHR组[恶性室性心律失常:29(11.2%) VS 9(4.0%),P=0.004;高度房室传导阻滞:22(8.5%) VS 6(2.7%),P=0.006;心源性休克+死亡:29(11.2%) VS 7(3.1%),P=0.001]。恶性室性心律失常、心源性休克+死亡患者LHR差异有统计学意义(P均<0.05)。Pearson相关分析显示,除高度房室传导阻滞(r=0.060,P>0.05)外,LHR与恶性室性心律失常(r=0.121)、心源性休克和死亡(r=0.115)均显著相关(P<0.05)。多因素Logistic回归分析显示,LHR、空腹血糖是STEMI患者发生院内MACE的独立危险因素(P均<0.05)。ROC曲线显示LHR预测STEMI患者院内MACE的曲线下面积为0.606(95%CI:0.544~0.668),cut-off值为2.854,敏感度为80.6%,特异度为52.1%;LHR>2.854时STEMI住院患者很可能会发生MACE。结论:STEMI患者LHR升高与恶性室性心律失常、心源性休克及死亡发生呈正相关。LHR是STEMI患者发生MACE的独立危险因素,对恶性室性心律失常、心源性休克及死亡发生有一定的预测价值。
文摘Dyslipidemia the major cause of atherosclerosis are suggested to act synergistically with non-lipid risk factors to increase atherogenesis.Low-density lipoprotein cholesterol(LDL-C) is the main therapeutic target in the prevention of CVD.Increased triglycerides(TG) and decreased high-density lipoprotein(LDL-C) are considered to be a major risk factor for the development of insulin resistant and metabolic syndrome.Although the TG/ HDL-C ratio has been used in recent studies as a clinical indicator for insulin resistance,results were inconsistent. The TG/HDL-C ratio is also widely used to assess the lipid atherogenesis.How ever the utility of this rate for predicting coronary heart disease(CHD) risk is not clear.We encountered myocardial infarct patients with normal serum lipid concentration so this study was undertaken to evaluate the usefulness of these lipid ratios in predicting CHD risk in normolipidemic AMI patients and to compare the results with healthy subjects.The aim of the present study was to evaluate serum TC/HDL-C,TG/HDL-C and LDL-C/HDL-C in myocardial infarct subjects with normal lipid profile.To study this,lipid profile was determined in 165 normolipidemic acute myocardial infarction patients and 165 age/sex-matched controls.Total cholesterol,triglycerides,and HDL-cholesterol were analyzed enzymatically using kits obtained from Randox Laboratories Limited,Crumlin,UK. Plasma LDL-cholesterol was determined from the values of total cholesterol and HDL- cholesterol using the friedwalds formula.The values were expressed as means±standard deviation(SD) and data from patients and controls was compared using students t-test.The results and conclusion of the study were:Total cholesterol, TC:HDL-C ratio,triglycerides,LDL-cholesterol,LDL:HDL-C ratio were higher in MI patients(p【0. 001).HDL-C concentration was significantly lower in MI patients than controls(p【0.001).Higher ratio of TC/HDL-C,TG/HDL-C and LDL-C/HDL-C was observed in AMI patients compared to controls.
