脂蛋白A与急性冠脉综合征预后的相关性分析

Correlation between Lipoprotein A and Prognosis of Acute Coronary Syndrome

摘要: 目的：探讨脂蛋白A对急性冠脉综合征(acute coronary syndrome, ACS)预后的相关性。方法：回顾性收集了自2016年6月~2020年6月青岛大学附属医院急性冠脉综合征患者391例，平均随访18月，将患者是否再次发生临床心脑血管不良事件分组。分别收集2组患者临床资料，对2组的年龄、性别、体指数、血压、血糖、血脂、Gensini评分等进行比较，采用单因素及多因素Logistic回归分析ACS预后的相关危险因素。同时使用Spearman相关性分析脂蛋白A与Gensini评分(冠脉血管严重程度)之间的关系。结果：脂蛋白A水平与冠脉血管严重程度有相关性(r = 0.119, P < 0.05)。多因素Logistic回归分析校正混杂因素后显示，糖尿病、脂蛋白A为ACS患者再次发生临床心脑血管不良事件的独立危险因素(P < 0.041 OR 1.1761 95%CI 1.023~3.034; P < 0.002 OR 1.002 95%CI 1.001~1.003)。结论：脂蛋白A与冠脉血管狭窄程度呈正相关性，且脂蛋白A和糖尿病均是ACS预后不良的独立危险因素。

Abstract: Objective: To investigate the correlation of lipoprotein A with prognosis of acute coronary syndrome (ACS). Methods: A total of 391 patients with acute coronary syndrome from June 2016 to June 2020 in affiliated Hospital of Qingdao University were collected retrospectively. The mean follow-up was 18 months, and the patients were divided into groups whether they had clinical cardiovascular and cerebrovascular adverse events again. The clinical data of the 2 groups were collected, and the age, sex, body index, blood pressure, blood glucose, blood lipids, Gensini score of the 2 groups were compared. The risk factors related to the prognosis of ACS were analyzed by univariate and multivariate Logistic regression. Spearman correlation was also used to analyze the relationship between lipoprotein A and Gensini score (coronary artery severity). Results: Lipoprotein A level was correlated with coronary artery severity (R = 0.119, P < 0.05). Multivariate Logistic regression analysis after adjusting showed that diabetes mellitus and lipoprotein A were independent risk factors for recurrent clinical cardiovascular and cerebrovascular adverse events in ACS patients (P < 0.041 OR 1.1761 95%CI 1.023 - 3.034; P < 0.002 OR 1.002 95%CI 1.001 - 1.003). Conclusion: Lipoprotein A is positively correlated with the degree of coronary artery stenosis, and both lipoprotein A and diabetes mellitus are independent risk factors for prognosis of ACS.