王莹,刘臣,周鹏,李健楠,周金英,赵霄潇,陈润真,宋莉,赵汉军,颜红兵

• 1:国家心血管病中心北京协和医学院中国医学科学院阜外医院冠心病中心
• 2:国家心血管病中心中国医学科学院阜外医院深圳医院心内科

摘要(Abstract)：

目的探讨接受经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI患者血浆脂蛋白(a)[Lp(a)]浓度与冠状动脉病变严重程度的关系及冠状动脉病变严重程度对患者预后的影响。方法回顾性研究连续入选2012年1月至2017年12月在阜外医院接受急诊PCI的STEMI患者,采用Gensini评分法评估冠状动脉病变严重程度,并将患者分为两组,分析其临床特征及对预后的影响。生存分析采用Kaplan-Meier法。采用logistic单因素和多因素回归分析Lp(a)与冠状动脉病变严重程度之间的关系。结果共纳入2374例患者,年龄(58.9±11.9)岁,男性1900例(80.0%)。随访时间为561(385,1631)d。Gensini评分与全因死亡、心原性死亡及主要不良心脑血管事件(MACCE)均显著相关(均P<0.05)。Pearson相关分析示lg [Lp(a)]与Gensini评分存在正相关(r=0.311,P<0.001)。logistic多因素回归分析示Lp(a)水平是冠状动脉复杂程度的独立预测因子(OR 1.010,95%CI 1.007～1.014,P<0.001)。结论对于接受急诊PCI的STEMI患者,高Gensini评分提示不良预后。Lp(a)是冠状动脉病变复杂程度的独立预测因子。

关键词(KeyWords)： 脂蛋白(a);ST段抬高型心肌梗死;经皮冠状动脉介入治疗;Gensini评分;预后

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王莹,刘臣,周鹏,李健楠,周金英,赵霄潇,陈润真,宋莉,赵汉军,颜红兵

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