摘要
目的评估血脂参数与中青年冠心病患者冠状动脉狭窄程度的相关性及其预测价值。方法以承德医学院附属医院2016年1月至2018年12月经冠状动脉造影诊断冠心病的中青年患者669例为研究对象,根据Gensini评分分为三组,轻度组229例,中度组214例,重度组226例。收集三组患者临床基本数据及血脂参数进行回顾性分析。结果三组患者间的体质量指数、吸烟、脉压、射血分数、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)、TC/HDL-C比值、TG/HDL-C比值、LDL-C/HDL-C比值、动脉粥样硬化指数(AI)、脂蛋白结合指数(LCI)、血浆致动脉粥样硬化指数(AIP)、血糖比较,差异具有统计学意义(χ^(2)/H/F=7.377、8.421、8.330、53.750、14.959、7.349、14.349、18.737、21.797、28.091、12.461、26.285、28.091、18.613、6.390、40.149,P<0.05)。TC、LDL-C、non-HDL-C、TC/HDL-C、LDL-C/HDL-C、AI、LCI与Gensini评分呈正相关(r=0.148、0.157、0.171、0.168、0.159、0.168、0.122,P<0.05)。LCI、AIP、射血分数是重度冠状动脉狭窄的影响因素(OR=0.990、0.180、0.944,P<0.05)。non-HDL-C、TC/HDL-C、LDL-C/HDL-C、AI的曲线下面积分别为0.574、0.554、0.549、0.554,P<0.05,敏感度为50.9%、57.1%、53.5%、57.1%;特异度为63.0%、54.2%、55.1%、54.2%。而联合上述血脂参数曲线下面积为0.599,P<0.05,敏感度为51.8%,特异度为66.1%。结论血脂参数与中青年冠心病患者冠状动脉狭窄程度有相关性,且联合检测血脂比值预测价值较好。
Objective To evaluate the correlation between blood lipid parameters and the degree of coronary artery stenosis in young and middle-aged patients with coronary heart disease(CHD)and its predictive value.Methods A total of 669 young and middle-aged patients with CHD diagnosed by coronary angiography of the Affiliated Hospital of Chengde Medical University from January 2016 to December 2018 were selected.Based on Gensini scores,they were divided into three groups:the mild group(229 cases),the moderate group(214 cases)and the severe group(226 cases).Basic clinical data and blood lipid parameters of the three groups were collected and analyzed retrospectively.Results The level of body mass index,smoking,pulse pressure,ejection fraction,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),non-HDL-C,TC/HDL-C ratio,TG/HDL-C ratio,LDL-C/HDL-C ratio,atherosclerosis index(AI),lipoprotein combine index(LCI),atherogenic index of plasma(AIP)and blood sugar were significantly different among the three groups(χ^(2)/H/F=7.377,8.421,8.330,53.750,14.959,7.349,14.349,18.737,21.797,28.091,12.461,26.285,28.091,18.613,6.390,40.149;P<0.05).TC,LDL-C,non-HDL-C,TC/HDL-C,LDL-C/HDL-C,AI and LCI were positively correlated with Gensini score(r=0.148,0.157,0.171,0.168,0.159,0.168,0.122;P<0.05).LCI,AIP were influencing factors for severe coronary artery disease(OR=0.990,0.180;P<0.05).The areas under the curve(AUC)of non-HDL-C,TC/HDL-C,LDL-C/HDL-C,and AI were 0.574,0.554,0.549,0.554,respectively(P<0.05),with sensitivities of 50.9%,57.1%,53.5%and 57.1%,and specificities of 63.0%,54.2%,55.1%and 54.2%,respectively.The AUC of the combined lipid parameters increased to 0.599(P<0.05),with a sensitivity of 51.8%and a specificity of 66.1%.Conclusion Blood lipid parameters are correlated with the degree of coronary artery stenosis in young and middle-aged CHD patients,and the predictive value is higher when combined with blood lipid ratio.
作者
王艳芳
刘超
丁振江
张文婧
刘秉时
韩冷
单伟超
Wang Yanfang;Liu Chao;Ding Zhenjiang;Zhang Wenjing;Liu Bingshi;Han Leng;Shan Weichao(Department of Cardiology,the Affiliated Hospital of Chengde Medical University,Chengde 067000,China)
出处
《心脑血管病防治》
2023年第12期28-32,共5页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
河北省政府资助专科带头人培养项目(361008)。
关键词
血脂参数
冠心病
中青年
冠状动脉狭窄程度
Blood lipid parameters
Coronary heart disease
Young and middle-aged adults
Degree of coronary artery stenosis
