摘要
目的探讨非高密度脂蛋白胆固醇(non-high density lipoprotein cholesterol,NHDL-C)对2型糖尿病并发急性ST段抬高性心肌梗死(acute ST-elevation myocardial infarction,STEMI)患者预后的影响。方法选择STEMI患者93例,分为STEMI并发糖尿病组(糖尿病组)36例,未并发糖尿病组(非糖尿病组)57例。分析全球急性冠状动脉事件注册(Global Registry of Acute Comnary Events,GRACE)危险评分与糖尿病并发急性心肌梗死及危险因素的相关性。结果糖尿病组Gensini评分、GRACE评分、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、载脂蛋白B(apolipoprotein B,ApoB)、NHDL-C/载脂蛋白A(apolipoprotein A-Ⅰ,ApoA-Ⅰ)均高于非糖尿病组,高密度脂蛋白胆固醇、ApoA-Ⅰ、体质量指数低于非糖尿病组;糖尿病组非致死性心肌梗死发生率、不良心血管事件发生率、因不良心血管事件再住院率明显高于非糖尿病组(P<0.05);Logistic回归分析结果显示,LDL-C、ApoB、NHDL-C/ApoA-Ⅰ、Gensini评分是影响STEMI预后的危险因素。结论对于2型糖尿病并发STEMI患者,NHDL-C/ApoA-Ⅰ明显影响预后,应重视NHDL-C水平的调控,或可进一步改善糖尿病并发急性心血管事件患者的预后。
Objective To investigate the effect of non high density lipoprotein cholesterol on the prognosis of patients with type 2 diabetes mellitus （T2DM） complicated with acute ST segment elevation myocardial infarction （STEMI）. Methods A total of 93 STEMI patients admitted to our hospital within 12 hours of symptom onset were enrolled in this study. All patients were divided into two groups： patients of STEMI with T2DM 36 cases and patients of STEMI without T2DM 57 cases.Results The patients with T2DM had significantly higher levels of Global Registry of Acute Coronary Events（GRACE） risk score, Gensini score, NHDL-C/ ApoA- I ,ApoB and low density lipoprotein cholesterol（LDL-C） than of patients without T2DM （all P〈0.05）.The patients with T2DM had significantly lower levels of high density lipoprotein cholesterol（HDL-C） ,ApoA- I and body mass index （BMI） than those of patients without T2DM （all P〈0.05）.The incidence of non fatal myocardial infarction,adverse cardiovascular events andthe rehospitalization rate due to adverse cardiovascular events were significantly higher than those of patients without T2DM （all P〈 0.05）. Logistic regression analysis with GRACE as the dependent variables showed that LDL-C, ApoB, NHDL-C/ApoA-I and Gensini score were positively correlated with GRACE risk score. Conclusion T2DM and GRACE risk score in patients with STEMI were closely associated.Non high density lipoprotein cholesterol and NHDL- C/ApoA-I were the most important factors of T2DM complicated with STEMI and positively correlated with STEMI severity as its independent factor.
出处
《河北医科大学学报》
CAS
2015年第9期1002-1005,1018,共5页
Journal of Hebei Medical University
基金
全军十二五面上项目(CWS11J215)
关键词
心肌梗死
糖尿病
2型
非高密度脂蛋白胆固醇
预后
myocardial infarction
diabetes mellitus, type 2
non-high density lipoprotein cholesterol
prognosis
