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- 2018
LDL-c/HDL-c与冠状动脉介入术后支架内再狭窄的相关性
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Abstract:
摘要：目的 探讨LDL-c/HDL-c与冠状动脉介入术后支架内再狭窄的关系。方法 应用回顾性研究的方法分析7年内在西安交通大学第二附属医院行冠脉支架术后造影的216名患者的临床资料。根据造影结果，将研究对象分为再狭窄组(73例)和非再狭窄组(143例)，分析两组患者的基本资料，并按照LDL-c/HDL-c的值，将216例患者分为3组，记为T1、T2、T3组，探讨LDL-c/HDL-c与支架内再狭窄的关系。结果 ①支架内再狭窄组的LDL-c/HDL-c水平显著高于非再狭窄组(P<0.01)；②高水平LDL-c/HDL-c组支架内再狭窄率高于低LDL-c/HDL-c组(P<0.05)；③多因素回归分析结果显示，LDL-c/HDL-c、糖尿病是支架内再狭窄的独立危险因素；④ROC曲线分析显示，LDL-c/HDL-c可预测支架内狭窄，灵敏度和特异度分别为78%、50%，曲线下面积为0.66(P<0.01)。结论 LDL-c/HDL-c与冠状动脉支架内再狭窄密切相关，是支架内再狭窄的独立危险因素。
ABSTRACT: Objective? ?To study the relationship between LDL-c/HDL-c ratio and instent restenosis (ISR) after percutaneous coronary intervention (PCI). Methods?? For this study we made a retrospective analysis of 216 patients who underwent stent implantation and received coronary angiography (CAG) from October 2009 to October 2016 in the Second Affiliated Hospital of Xi’an Jiaotong University. The subjects were divided into ISR group (73 cases) and non-ISR group (163 cases) based on CAG outcome. Then based on the general data and LDL-c/HDL-c ratio of the two groups of patients, we marked them as T1, T2 and T3 groups to explore the relationship between LDL-c/HDL-c and ISR. Results? ?① Compared with that in the control group, LDL-c/HDL-c ratio was significantly higher in ISR group (P<0.01). ② ISR was higher in high LDL-c/HDL-c group than in low LDL-c/HDL-c group (P<0.05). ③ Multivariate logistic regression analysis showed that LDL-c/HDL-c ratio and diabetes mellitus were independent risk factors for ISR in patients who underwent stent implantation. ④ In receiver operating characteristics curve analysis, LDL-c/HDL-c level had 78% sensitivity and 50% specificity (AUC: 0.66, P<0.01) in predicting ISR (P<0.01). Conclusion?? LDL-c/HDL-c ratio is closely correlated with in-stent restenosis after stent implantation in coronary artery and is its independent risk factor
| [1] | 韩艳，高传玉，程兆云，等. ApoB/A1比值与支架内再狭窄相关性研究[J]. 中国心血管病研究, 2014, 12(1):21-26. |
| [2] | HUANG CH , CHANG CC , HUANG CS , et al. Using oxidized low-density lipoprotein autoantibodies to predict restenosis after balloon angioplasty in patients with acute myocardial infarction[J]. PLoS One, 2013, 8(10):e74726. |
| [3] | AGGARWAL J, REDDY S, NAGTILAK S. Evaluation of non-HDL-cholesterol/HDL-cholesterol ratio as a predictor of coronary artery disease[J]. Inter J Adv Res, 2014, 2(5):277-283. |
| [4] | CAMPO G, TEBDLDI M, VRANCKX P, et al. Short-versus long-term duration of dual antiplatelet therapy in patients treated for in-stent restenosis: A PRODIGY trial substudy (prolonging dual antiplatelet treatment after grading stent-induced intimal hyperplasia)[J]. J Am Coll Cardiol, 2014, 63(63):506-512. |
| [5] | UCAR FM. A potential marker of bare metal stent restenosis: Monocyte count-to-HDL cholesterol ratio[J]. BMC Cardiovasc Disord, 2016, 16(1):186. |
| [6] | TOK D, TURAK O, YAYLA ？s, et al. Monocyte to HDL ratio in prediction of BMS restenosis in subjects with stable and unstable angina pectoris[J]. Biomark Med, 2016, 10(8):853-860. |
| [7] | SEO SM, CHOO EH, KOH YS, et al. High-density lipoprotein cholesterol as a predictor of clinical outcomes in patients achieving low-density lipoprotein cholesterol targets with statins after percutaneous coronary intervention[J]. Heart, 2011, 97(23):1943-1950. |
| [8] | BHARADWAJ P, CHADHA DS. Drug eluting stents: To evolve or dissolve?[J]. Med J Armed Forces India, 2016, 72(4):367-372. |
| [9] | GHAZZAL ZB, DHAWAN SS, SHEIKH A, et al. Usefulness of serum high-density lipoprotein cholesterol level as an independent predictor of one-year mortality after percutaneous coronary interventions[J]. Am J Cardiol, 2009, 103(7):902-906. |
| [10] | NAKAMURA H, MIZUNO K. Abstract 6282: Lowered ratio of low-density lipoprotein cholesterol to high-density lipoprotein cholesterol with lipid lowering therapy associated with reduction of cardiovascular events in primary prevention: MEGA study post-hoc analysis[J]. Circulation, 2008, 118(18):S1174. |
| [11] | VON BIRGELEN C, HARTMANN M, MINTZ GS, et al. Relationship between cardiovascular risk as predicted by established risk scores versus plaque progression as measured by serial intravascular ultrasound in left main coronary arteries[J]. Circulation, 2004, 110(12):1579-1585. |
| [12] | 王超权，徐耕，程刚，等.冠状动脉支架植入术后再狭窄与临床血清学指标的关系探讨[J].心脑血管病防治, 2009,9(2):84-86. |
| [13] | 张文广，裴汉军，吴永健,等.药物洗脱支架治疗糖尿病合并冠状动脉支架内再狭窄远期疗效及安全性观察[J].中国循环杂志, 2013, 28(2):96-99. |
| [14] | 马维冬，刘晓唤，张春艳，等. 非糖尿病患者糖化血红蛋白、纤维蛋白原、及胱抑素C与冠脉狭窄程度的关系[J]. 西安交通大学学报(医学版)，2016, 37(3):344-348. |
