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急性肺栓塞患者血清胆固醇水平与短期死亡率的关联

Association of Serum Cholesterol Levels with Short-term Mortality in Patients with Acute Pulmonary Embolism.

作者信息

Karataş Mehmet Baran, Güngör Barış, İpek Göktürk, Çanga Yiğit, Günaydın Zeki Yüksel, Onuk Tolga, Durmuş Gündüz, Yelgeç Nizamettin Selçuk, Yılmaz Hale Yaka, Bolca Osman

机构信息

Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.

Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.

出版信息

Heart Lung Circ. 2016 Apr;25(4):365-70. doi: 10.1016/j.hlc.2015.09.005. Epub 2015 Oct 9.

Abstract

BACKGROUND

Serum cholesterols play an important role in pathophysiology and prognosis of acute thrombotic diseases. The aim of the present study was to investigate the prognostic value of serum lipid parameters in acute pulmonary embolism (APE).

METHODS

From January 2008 to January 2014 a total of 275 patients who were hospitalised with a diagnosis of APE were retrospectively screened. Clinical data, laboratory parameters, serum cholesterol levels were recorded and pulmonary embolism severity index (PESI) scores were calculated. Mortality rate at 30 days was investigated as the clinical outcome.

RESULTS

In our study population, 24 patients (8.7%) died within 30 days. Serum total cholesterol, LDL-C, HDL-C and triglyceride levels were significantly lower in deceased patients when compared to the survived patients (3.1 ± 0.6 vs. 4.7 ± 1.2 mmol/L, p < 0.01; 1.8 ± 0.9 vs. 2.9 ± 0.9 mmol/L, p < 0.01; 0.9 ± 0.3 vs. 1.2 ± 0.3 mmol/L, p < 0.01; 1.4 ± 0.7 vs. 1.7 ± 0.6 mmol/L, p = 0.04, respectively). In multivariate regression analysis; PESI scores (OR: 1.06 95% CI: 1.01-1.11, p < 0.01), right ventricular diameter (OR: 11.31 95% CI: 3.25-52.64, p < 0.01), total cholesterol (OR: 1.09 95% CI: 1.02-1.17, p < 0.01), LDL-C (OR: 1.06 95% CI: 1.01-1.12, p = 0.02), HDL-C (OR: 1.21 95% CI: 1.04-1.41, p < 0.01) and triglyceride (OR: 1.03 95% CI: 1.01-1.05, p < 0.01) levels were independently correlated with mortality.

CONCLUSIONS

Serum total cholesterol, LDL-C, HDL-C and triglyceride levels, obtained within the first 24hours of hospital admission, may have prognostic value in patients with APE.

摘要

背景

血清胆固醇在急性血栓性疾病的病理生理学和预后中起重要作用。本研究的目的是探讨血清脂质参数在急性肺栓塞(APE)中的预后价值。

方法

回顾性筛查2008年1月至2014年1月期间共275例诊断为APE并住院的患者。记录临床资料、实验室参数、血清胆固醇水平,并计算肺栓塞严重程度指数(PESI)评分。以30天死亡率作为临床结局进行调查。

结果

在我们的研究人群中,24例患者(8.7%)在30天内死亡。与存活患者相比,死亡患者的血清总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯水平显著降低(分别为3.1±0.6 vs. 4.7±1.2 mmol/L,p<0.01;1.8±0.9 vs. 2.9±0.9 mmol/L,p<0.01;0.9±0.3 vs. 1.2±0.3 mmol/L,p<0.01;1.4±0.7 vs. 1.7±0.6 mmol/L,p = 0.04)。在多因素回归分析中;PESI评分(OR:1.06,95%CI:1.01-1.11,p<0.01)、右心室直径(OR:11.31,95%CI:3.25-52.64,p<0.01)、总胆固醇(OR:1.09,95%CI:1.02-1.17,p<0.01)、低密度脂蛋白胆固醇(OR:1.06,95%CI:1.01-1.12,p = 0.02)、高密度脂蛋白胆固醇(OR:1.21,95%CI:1.04-1.41,p<0.01)和甘油三酯(OR:1.03,95%CI:1.01-1.05,p<0.01)水平与死亡率独立相关。

结论

入院后24小时内测得的血清总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯水平可能对APE患者具有预后价值。

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