摘要
目的探讨血清总胆固醇(TC)、甘油三酯(TG)及载脂蛋白B(ApoB)在输血后脂质代谢监测中的应用价值。方法回顾性纳入2022年7月至2023年10月南京医科大学附属淮安第一医院收治的外伤失血性休克患者152例,依据脂质代谢诊断标准将152例患者分为脂质代谢正常组86例、脂质代谢异常组66例。比较两组一般资料、TC、TG及ApoB水平变化;分析影响输血后脂质代谢异常的危险因素,绘制ROC曲线评估TC、TG及ApoB单独及联合检测对输血后脂质代谢异常的预测价值。结果两组年龄、性别、吸烟史、饮酒史、糖尿病史、高血压史占比、输血量比较,差异无统计学意义(P>0.05);脂质代谢异常组年高密度脂蛋白胆固醇水平低于脂质代谢正常组,低密度脂蛋白胆固醇水平高于脂质代谢正常组,差异有统计学意义(P<0.05)。脂质代谢异常组TC、TG及ApoB水平均明显高于脂质代谢正常组,差异有统计学意义(P<0.05)。经logistic多因素分析显示:高密度脂蛋白胆固醇(男性<0.91 mmol/L,女性<1.1 mmol/L)、低密度脂蛋白胆固醇(>4.14 mmol/L)、TC(<2.4 mmol/L,>5.7 mmol/L)、TG(<0.4 mmol/L,>1.8 mmol/L)及ApoB(男性<0.43 g/L,>1.28 g/L,女性<0.42 g/L,>1.12 g/L)是影响输血后脂质代谢异常的危险因素(P<0.05)。依据ROC曲线可知,TC、TG及ApoB联合预测输血后脂质代谢异常的敏感度和特异度分别为89.84%、88.24%,AUC为0.898,高于三指标单独检测(P<0.05)。结论TC、TG及ApoB在输血后脂质代谢异常患者中呈高表达,三指标联合检测可全面、客观地反映输血后脂质代谢异常情况,为临床诊断、治疗提供更为准确、可靠的依据。
Objective To explore the application value of serum total cholesterol(TC),triglyceride(TG)and apolipoprotein B(ApoB)in the monitoring of lipid metabolism after blood transfusion.Methods A total of 152 patients with traumatic hemorrhagic shock were admitted to Huai'an First Hospital Affiliated with Nanjing Medical University from July 2022 to October 2023.These patients were retrospectively included in the study.Based on the diagnostic criteria for lipid metabolism,the patients were divided into two groups:those with normal lipid metabolism group(n=86)and those with abnormal lipid metabolism group(n=66).General data,TC,TG,and ApoB levels were compared between the two groups.The study also analyzed the risk factors associated with abnormal lipid metabolism after blood transfusion.Additionally,a ROC curve was created to assess the predictive value of single and combined detection of TC,TG,and ApoB on abnormal lipid metabolism following blood transfusion.Results There were no significant differences in age,sex,smoking history,drinking history,history of diabetes,history of hypertension and blood transfusion between the two groups(P>0.05).The level of high⁃density lipoprotein cholesterol in the abnormal lipid metabolism group was lower than that in the normal lipid metabolism group,and the level of low⁃density lipoprotein cholesterol was higher than that in the normal lipid metabolism group,the differences were statistically significant(P<0.05).The levels of TC,TG,and ApoB in the abnormal lipid metabolism group were significantly higher than those in the normal lipid metabolism group(P<0.05).Logistic multivariate analysis showed that high density lipoprotein cholesterol(male<0.91 mmol/L,female<1.1 mmol/L),low⁃density lipoprotein cholesterol(>4.14 mmol/L),TC(5.7 mmol/L),TG(1.8 mmol/L)and ApoB(male 1.28 g/L,female 1.12 g/L)were risk factors for abnormal lipid metabolism after blood transfusion(P<0.05).According to the ROC curve,the sensitivity and specificity of TC,TG,and ApoB combined to predict abnormal lipid me
作者
臧炫月
王明星
张刘仟
文柯
ZANG Xuanyue;WANG Mingxing;ZHANG Liuqian;WEN Ke(Department of Blood Transfusion,Huaian First Hospital Affiliated to Nanjing Medical University,Huaian,Jiangsu,China,223300;Department of Clinical Laboratory,Huaian First Hospital Affiliated to Nanjing Medical University,Huaian,Jiangsu,China,223300)
出处
《分子诊断与治疗杂志》
2024年第11期2202-2205,2210,共5页
Journal of Molecular Diagnostics and Therapy
基金
江苏省自然科学基金青年基金项目(2022152)。
关键词
总胆固醇
甘油三酯
载脂蛋白B
输血
脂质代谢
Total cholesterol
Triglyceride
Apolipoprotein B
Blood transfusion
Lipid metabolism
