摘要
目的分析冠心病患者血清胱抑素C水平与罹患房颤的相关性,并评估其临床价值。方法选择住院确诊的稳定型冠心病合并房颤的患者75例,同时人选年龄、性别匹配的冠心病非房颤患者90例,采集人选患者的临床病史、血压、心脏彩超检查结果,肾功能检查结果、血脂、血清胱抑素C水平。结果(1)房颤组中尿素氮(P<0.0001)、肌酐(P<0.0001)、尿酸水平(P=0.04)、左房内径(P<0.0001)、左室舒张末内径(P<0.0001)及血清胱抑素C水平(P<0.0001)均较非房颤组显著升高,而射血分数明显降低(P=0.01)。(2)Logistic回归结果表明:经校正性别、年龄、血压、吸烟史、尿素氮、肌酐、尿酸、左室舒张末内径及射血分数后,左房内径及血清胱抑素C水平为冠心病患者发生房颤的独立危险因素。(3)受试者工作特征曲线(ROC曲线)显示,血清胱抑素C及左房内径对冠心病患者罹患房颤均具有评估价值(P<0.0001),当胱抑素C水平>0.88mg/L及左房内径>40.5mm时,诊断敏感性分别为92.0%及68.0%。结论血清胱抑素C水平及左房内径与冠心病患者房颤易感性独立相关,ROC曲线分析提示血清胱抑素C对冠心病患者罹患房颤的评估价值比左房内径更优。
Objective To analyze the correlation between serum cystatin C level and atrial fibrillation in patients with coronary heart disease,and evaluate its clinical value.Methods 75 hospitalized patients with stable coronary heart disease complicated with atrial fibrillation were selected,and 90 age-matched and gender matched patients with non-atrial fibrillation were selected.The clinical history,blood pressure,color Doppler echocardiography results,renal function test results,blood lipids,and serum cystatin C levels of the selected patients were collected.Results(1)In AF group,urea nitrogen(P<0.0001),creatinine(P<0.0001),uric acid(P=0.04),left atrial diameter(P<0.0001),left ventricular end diastolic diameter(P<0.0001)and serum cystatin C level(P<0.0001)were significantly higher than those in non AF group,while ejection fraction was significantly lower(P=0.01).(2)Logistic regression results showed that after adjusting for gender,age,blood pressure,smoking history,urea nitrogen,creatinine,uric acid,left ventricular end diastolic diameter and ejection fraction,left atrial diameter and serum cystatin C level were independent risk factors for atrial fibrillation in patients with coronary heart disease.(3)The receiver operating characteristic curve(ROC curve)showed that serum cystatin C and left atrial diameter had evaluation value for atrial fibrillation in patients with coronary heart disease(P<0.0001).When cystatin C level>0.88 mg/L and left atrial diameter>40.5 mm,the diagnostic sensitivity was 92.0%and 68.0%respectively.Conclusion Serum cystatin C level and left atrial diameter were independently related to the susceptibility to atrial fibrillation in patients with coronary heart disease.ROC curve analysis showed that serum cystatin C had a better evaluation value for atrial fibrillation in patients with coronary heart disease than left atrial diameter.
作者
朱桢燕
王卫明
程亚敏
钱四辈
杨玲
ZHU Zhen-yan;WANG Wei-ming;CHENG Ya-min;QIAN Si-bei;YANG Ling(Department of Cardiovascular,Changzhou No.1 People's Hospital,Changzhou,Jiangsu,213003,China)
出处
《中国血液流变学杂志》
CAS
2023年第1期53-56,共4页
Chinese Journal of Hemorheology
基金
常州市卫健委指导性科技项目(WZ201709)。
关键词
血清胱抑素C
冠心病
房颤
serum cystatin C
coronary artery disease
atrial fibrillation
