代谢指标异常与急性冠脉综合征患者冠状动脉病变程度的相关性

赵亚军; 刘明; 戴宇翔; 李小攀; 程雪霖; 王启哲; 刘茹; 许雅鑫; 江孙芳

doi:10.12025/j.issn.1008-6358.2025.20250342

代谢指标异常与急性冠脉综合征患者冠状动脉病变程度的相关性

The correlation between abnormal metabolic indexes and the severity of coronary artery lesions in patients with acute coronary syndrome

摘要

摘要:
目的探讨急性冠脉综合征（acute coronary syndrome，ACS）患者冠状动脉病变程度的影响因素。
方法连续性收集2017年12月至2019年12月复旦大学附属中山医院ACS患者的临床资料。采用改良Gensini评分评估患者冠状动脉病变的严重程度。通过单因素和多因素线性回归分析探讨ACS患者冠状动脉病变严重程度的影响因素。
结果共纳入1 689例ACS患者，年龄（64.04±11.45）岁，男性1 353例（80.11%），改良Gensini评分（8.12±4.03）分。多因素线性回归分析显示，性别（β＝0.97，P＝0.001）、年龄（β＝0.03，P＝0.021）、估算肾小球滤过率（estimated glomerular filtration rate，eGFR；β＝－0.03，P＜0.001）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C；β＝0.58，P＜0.001）、载脂蛋白A1（apolipoprotein A1，Apo A1；β＝－1.28，P＝0.012）、脂蛋白alipoprotein(a)，Lp(a)；β＝0.001，P＝0.033和糖化血红蛋白（glycated hemoglobin A_1C，HbA_1C；β＝0.45，P＜0.001）是改良Gensini评分的独立影响因素。
结论代谢指标Apo A1、LDL-C、HbA_1C和Lp(a)可能是ACS患者冠状动脉病变程度的风险因素，其中Apo A1的影响作用最大。

Abstract:
Objective To explore the influencing factors of coronary artery lesion severity in patients with acute coronary syndrome (ACS).
Methods Clinical data of ACS patients admitted to Zhongshan Hospital, Fudan University from December 2017 to December 2019 were consecutively collected. The modified Gensini score was used to assess the severity of coronary artery lesions. Univariate and multivariate linear regression analyses were performed to identify independent factors associated with coronary artery lesion severity.
Results A total of 1 689 ACS patients were included, with an average age of (64.04±11.45) years; 1 353 (80.11%) were male, and the mean modified Gensini score was (8.12±4.03). Multivariate linear regression analysis revealed that sex (β＝0.97, P＝0.001), age (β＝0.03, P＝0.021), estimated glomerular filtration rate (eGFR; β＝－0.03, P＜0.001), low-density lipoprotein cholesterol (LDL-C; β＝0.58, P＜0.001), apolipoprotein A1 (Apo A1; β＝－1.28, P＝0.012), lipoprotein(a) Lp(a); β＝0.001, P＝0.033, and glycated hemoglobin A_1C (HbA_1C; β＝0.45, P＜0.001) were independent influencing factors of the modified Gensini score.
Conclusions Metabolic indicators, including Apo A1, LDL-C, HbA_1C, and Lp(a), may serve as risk factors for coronary artery lesion severity in ACS patients, with Apo A1 demonstrating the strongest impact.

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