首页|血浆ApoB/ApoA1比值和D-二聚体水平的列线图模型对急性ST段抬高型心肌梗死患者PCI术后左心室血栓形成的预测价值

血浆ApoB/ApoA1比值和D-二聚体水平的列线图模型对急性ST段抬高型心肌梗死患者PCI术后左心室血栓形成的预测价值

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[目的]分析血浆ApoB/ApoA1比值和D-二聚体(D-D)对急性ST段抬高型心肌梗死(STEMI)患者PCI术后左心室血栓形成(LVT)的预测价值,并建立列线图模型.[方法]选取2021年1月-2022年12月阜阳市第六人民医院收治的187例STEMI患者.根据患者术后28天随访结果,将患者分为LVT组和非LVT组.对两组患者血浆ApoB/ApoA1比值和D-D水平等临床资料进行单因素和二元Logistic回归分析,探索STEMI患者PCI术后LVT形成的独立危险因素,建立列线图模型,并对列线图模型的诊断效能进行评价.[结果]血浆ApoB/ApoA1 比值升高(OR=1.320,95%CI:1.057~1.648)、D-D 水平增加(OR=1.031,95%CI:1.020~1.042)、术前TIMI 为 0 级(OR=4.141,95%CI:1.018~16.849)及左心室射血分数(LVEF)降低(OR=0.906,95%CI:0.853~0.963)是PCI术后LVT形成的独立危险因素(P<0.05),上述指标预测LVT形成的AUC分别为0.792、0.800、0.623和0.726.基于以上指标建立列线图模型,ROC曲线分析表明,模型一致性指数为0.926,校正曲线显示该模型具有良好的区分度和一致性.[结论]STEMI患者血浆ApoB/ApoA1比值升高和D-D水平增加与PCI术后LVT形成具有密切关系,基于上述指标建立的列线图模型对预测LVT有较高的诊断效能,有利于临床医务人员对高危患者的识别.
The predictive value of a column chart model with plasma ApoB/ApoA1 ratio and D-dimer levels for left ventricular thrombosis after PCI in patients with acute ST seg-ment elevation myocardial infarction
Aim To analyze the predictive value of plasma ApoB/ApoA ratio and D-dimer(D-D)levels for left ventricular thrombosis(LVT)after PCI in patients with acute ST-segment elevation myocardial infarction(STEMI),and establish a column chart model.Methods 187 STEMI patients admitted to Fuyang Sixth People's Hospital from Janu-ary 2021 to December 2022 were selected.According to the follow-up results 28 days after surgery,the patients were di-vided into LVT group and non LVT group.The study conducted univariate and binary Logistic regression analysis on clini-cal data such as plasma ApoB/ApoA1 ratio and D-D in the two groups of patients,identified independent risk factors for LVT formation in STEMI patients after PCI,established a column chart model,and evaluated the diagnostic efficacy of the column chart model.Results The results showed that an increase in the ApoB/ApoA1 ratio(OR=1.320,95%CI:1.057~1.648),an increase in D-D levels(OR=1.031,95%CI:1.020~1.042),a preoperative TIMI of 0(OR=4.141,95%CI:1.018~16.849),and a decrease in LVEF(OR=0.906,95%CI:0.853~0.963)were independent risk factors for LVT formation after PCI(P<0.05),and the AUC predicted by the above indicators for LVT formation were 0.792,0.800,0.623 and 0.726,respectively.Based on the above indicators,a column chart model was established.ROC curve analysis showed that the consistency index of the model was 0.926,and the calibration curve showed that the model had good discrimination and consistency.Conclusions The increase in plasma ApoB/ApoA1 ratio and D-D levels in STEMI patients is closely related to the formation of LVT after PCI.The column chart model established based on the above indicators has high diagnostic efficacy in predicting LVT,which is beneficial for clinical medical staff to iden-tify high-risk patients.

ST-segment elevation myocardial infarctionapolipoprotein Bapolipoprotein A1D-dimerleft ventricular thrombosis

赵德轩、刘慧、贾蕾蕾

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阜阳市第六人民医院心内科,安徽省阜阳市 236000

ST段抬高型心肌梗死 载脂蛋白B 载脂蛋白A1 D-二聚体 左心室血栓形成

安徽省卫生健康科研立项项目(2022)

AHWJ2022a043

2024

中国动脉硬化杂志
中国病理生理学会 南华大学

中国动脉硬化杂志

CSTPCD
影响因子:1.086
ISSN:1007-3949
年,卷(期):2024.32(3)
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