实用心电与临床诊疗2025，Vol.34Issue(5)：712-716,725,6.DOI:10.13308/j.issn.2097-5716.2025.05.016
残余胆固醇联合心率变异性对冠心病患者住院期间主要不良心血管事件风险的预测价值
Predictive value of remnant cholesterol combined with heart rate variability for risk of major adverse cardiovascular events in patients with coronary heart disease during hospitalization
摘要
Abstract
Objective To investigate the independent and combined predictive value of remnant cholesterol(RC)and heart rate variability(HRV)for major adverse cardiovascular events(MACEs)in patients with coronary heart disease(CHD)during hospitalization,aiming to provide a new assessment tool for clinical risk stratification and precise intervention.Methods A total of 332 patients with CHD were selected as study subjects.Data including age,sex,smoking history,blood pressure,echocardiographic parameters,serum total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)were recorded.Average heart rate,and HRV indexes including SDNN,triangular index,SDNN index,rMSSD and pNN50 were recorded via 24-hour ambulatory electrocardiography monitoring.Based on the occurrence of MACEs during hospitalization,these patients were divided into a MACEs group(44 cases)and a non-MACEs group(288 cases).Multivariate Logistic regression analysis was used to explore influencing factors for MACEs in patients with CHD during hospitalization.ROC curves were plotted to evaluate the predictive efficiency of RC and SDNN for MACEs.Results Neutrophil count,and triglyceride,TC and RC levels were all significantly higher in the MACEs group than those in the non-MACEs group(all P＜0.01);HDL-C and SDNN were significantly lower in the MACEs group(both P＜0.05).Multivariate Logistic regression analysis showed that RC(OR=1.275,95％CI 1.145-1.419,P＜0.01)and SDNN(OR=0.967,95％CI 0.951-0.982,P＜0.01)were independent influencing factors for MACEs in CHD patients.ROC curve analysis revealed that the AUC values for predicting MACEs in CHD patients using RC and SDNN were 0.755(95％CI 0.662-0.848,P＜0.01)and 0.771(95％CI 0.703-0.840,P＜0.01),respectively.The AUC value of the combined prediction of RC and SDNN for MACEs was 0.845(95％CI 0.779-0.910,P＜0.01).Conclusion Both RC and SDNN could independently predict the risk of MACEs in CHD patients during hospitalization.Their combined assessment model demonstrates higher predictive efficiency and clinical utility.关键词
残余胆固醇/心率变异性/冠心病/动态心电图Key words
remnant cholesterol/heart rate variability/coronary heart disease/ambulatory electrocardiography分类
医药卫生引用本文复制引用
毛洁,杨龙,范平..残余胆固醇联合心率变异性对冠心病患者住院期间主要不良心血管事件风险的预测价值[J].实用心电与临床诊疗,2025,34(5):712-716,725,6.基金项目
新疆维吾尔自治区卫生健康科技计划项目(2025001MXJCSYJSTGXM650030286) （2025001MXJCSYJSTGXM650030286）
