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目的 探讨视黄醇结合蛋白(RBP)4、多配体聚糖(SDC)-1联合单核细胞/高密度脂蛋白胆固醇比值(MHR)在老年急性冠状动脉综合征(ACS)的预测价值。方法 选取ACS患者280例，包括急性心肌梗死患者130例和不稳定性心绞痛患者150例，根据Gensini冠状动脉动病变评分分为1级组(0～30分)、2级组(31～60分)和3级组(>60分)。根据患者1年内有无发生主要不良心血管事件(MACE)分为MACE组和无MACE组。收集患者性别、年龄、既往史、吸烟史、家族史、体质量指数(BMI);入院后检测血常规、血脂、SDC-1和RBP4;计算MHR、血浆致动脉硬化指数(AIP)和Gensini评分，通过电话及门诊随访1年内患者发生MACE的情况。结果 Gensini评分不同分组之间性别、年龄、既往史、吸烟史、家族史、BMI比较，无统计学差异(P>0.05)。Gensini评分3级组MHR、SDC-1、RBP4、AIP高于2级组和1级组，2级组高于1级组，组间比较有统计学差异(P<0.05)。急性心肌梗死患者MHR、SDC-1、RBP4、AIP高于不稳定性心绞痛患者，MACE组MHR、SDC-1、RBP4、AIP指标高于无MACE组，组间比较有统计学差异(P<0.05)。相关分析显示，RBP4、SDC-1、MHR与Gensini评分呈正相关(r=0.834、0.773、0.728,均P<0.001)。采用多个自变量的逐步Logistic回归结果显示，ACS患者RBP4、SDC-1、MHR升高后发生MACE的危险因素增加。受试者工作特性(ROC)曲线显示，RBP4、SDC-1、MHR对老年ACS患者并发MACE均有预测价值，而联合检测的曲线下面积(AUC)为0.795,预测价值最高。结论 RBP4、SDC-1、MHR提高了评估老年ACS患者冠状动脉病变严重程度及MACE发生风险的灵敏度，有助于早期预测ACS的高危人群。
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基本信息:
中图分类号:R541.4
引用信息:
[1]李瑞春,王雅,李敬.RBP4、SDC-1联合MHR对老年急性冠脉综合征的风险预测价值[J].中国老年学杂志,2026,46(06):961-964.
基金信息:
2023年度河北省医学科学研究重点课题(20232179)
2026-03-25
2026-03-25