血清Lp(a)、HCY、Lp-PLA2水平与 STEMI患者冠脉狭窄程度的相关性及对PCI术后MACE的预测价值

打开文本图片集

关键词：心肌梗死；脂蛋白（a）；同型半胱氨酸；脂蛋白相关磷脂酶A2；MACE；预后中图分类号：R541.4 文献标识码：A

DOI：10.3969/j.issn.1006-1959.2025.23.008 文章编号：1006-1959（2025）23-0044-08

Correlation Between Serum Lp（a），HCY，Lp-PLA2 Levels and the Degree of Coronary Stenosis inPatientswithSTEMIandTheirPredictiveValueforMACEAfterPCI

ZHANGQuyang，ZHANGYichun （Department of Cardiology，Anqing Municipal Hospital，Anqing 246O03，Anhui，China）

Abstract：Oe （Lp-PA）levesdfoarteosisiatitsiutegteatiooadalifarctio（d predictivevalueforardiovasculardveseevents（MACE）fterperutaneouscoronaryintervention（PC）MethodsFromJauaryt December3tsiialdialsialdeths astheobseatigrodatitsoeospialdateeiiiousseoofayaeeted thecontrolgroup.Theobservatiogroupasiidedintoildstenosisoup（67patints）andseveestenosisgroup83patients）codigto Gensiniscore.After1yearoffolowuptheobservationgroupasdividedintoMACEgroupandnon-MACEgoupaccordingtowhetherMACE ocurredevelsf），eiootrooeoedSeaaal wasusedtoaet）yeoosisUaeilt regresionadCOegesoedtoaeeefroayosisddepedeisfctoforACEpredictiec ofserumLp（a），HcyndLp-PLAonMACEwasanalyzdbyreceiveroperatingcharacteristic（ROC）curveandareaundertheurve（UC）. ResultsTheveofrLa），ydLAinbseaioopegraoetotroloune stisticallso）i degree of coronary artery stenosis （r=0.476，0.438，0.447，all P<0.001 ）.MultivariateLogisticregressionshowed thatLp（a），HCY，Lp-PLA2，EF value andLDL-C were independent risk factors for theseverityof coronary arterydiseasein STEMI patients（ P<0.05） .Multivariate COX regression showed thatLp（a），HCYandLp-PLA2 were independent risk factors for MACEin STEMI patientsafter PCI（ P<0.05） .ROC curve showed that serumLp（a），

HCY，Lp-LAevesdatioofeedditieaciditigCEitisdUf thecombinationoftereestelgestCocusioelevelsofLa），HCdL-Ainpatientsrerelatedte oforonarysteosisdeodicietoeoCEotaiofLd Lp-PLA2 hasthehighest predictive effect on MACE.

KeyWords：Mycadialifarction;Lipoprotein（a）;Homocysteine;LioproteinssociatedphospholipaseA2;MACE;rogosi

急性ST段抬高型心肌梗死（ST-segmenteleva-tionmyocardialinfarction，STEMI）多数以动脉粥样硬化为基础，发生冠脉血供减少或中断，使对应心肌出现严重的缺血缺氧，而梗死出现的常见原因是不稳定粥样斑块破裂进而引发血栓形成，导致冠脉完全闭塞。（剩余11185字）