摘要
目的探讨单核细胞/高密度脂蛋白胆固醇比值(MHR)及CHA_(2)DS_(2)-VASc-HSF评分对冠心病及冠状动脉(简称冠脉)病变程度的预测价值。方法纳入疑诊冠心病并行冠脉造影检查的患者370例,根据冠脉造影结果将其分为冠心病组290例和非冠心病组80例;再根据冠脉病变支数将冠心病组患者分为单支病变组121例、双支病变组88例和多支病变组81例。比较各组患者的临床资料。采用多因素logistic回归分析探讨冠心病及冠脉病变程度的影响因素;采用受试者工作特征(ROC)曲线评估MHR及CHA_(2)DS_(2)-VASc-HSF评分对冠心病及冠脉病变严重程度的预测价值。结果冠心病组患者MHR、CHA_(2)DS_(2)-VASc-HSF评分均高于非冠心病组(P<0.05)。单支病变组、双支病变组、多支病变组MHR及CHA_(2)DS_(2)-VASc-HSF评分依次升高(P<0.05)。多因素logistic回归分析结果显示,男性及CHA_(2)DS_(2)-VASc-HSF评分升高为冠心病发病的独立危险因素,空腹血糖、MHR升高为冠脉多支病变的独立危险因素(P<0.05)。ROC曲线分析结果显示,MHR、CHA_(2)DS_(2)-VASc-HSF评分预测冠心病的最佳临界值分别为0.397、1.5分,两者联合对冠心病的预测价值更大,ROC曲线下面积(AUC)为0.733。MHR、CHA_(2)DS_(2)-VASc-HSF评分预测冠脉多支病变的AUC分别为0.587、0.642,两者联合对冠脉病变程度的预测价值更大,AUC为0.661。结论MHR及CHA_(2)DS_(2)-VASc-HSF评分可作为冠心病及冠脉病变程度有价值的预测指标,两者联合对冠心病及冠脉病变程度的预测价值较大。
Objective To explore the value of monocyte to high density lipoprotein cholesterol ratio(MHR)and CHA_(2)DS_(2)-VASc-HSF score in predicting the severity of coronary heart disease(CHD)and severity of coronary artery lesion.Methods A total of 370 patients with suspected CHD were divided into CHD group(290 cases)and non-CHD group(80 cases)according to the results of coronary artery angiography,and patients in CHD group were divided into single-vessel disease group(121 cases),doublevessel disease group(88 cases)and multi-vessel disease group(81 cases)according to the number of coronary artery lesions.Clinical data of each group were compared.Multivariate logistic regression analysis was used to evaluate influencing factors of CHD and severity of coronary artery lesion.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of MHR and CHA_(2)DS_(2)-VASc-HSF score for CHD and severity of coronary artery lesion.Results MHR and CHA_(2)DS_(2)-VASc-HSF score in CHD group were significantly higher than those in non-CHD group(P<0.05).MHR and CHA_(2)DS_(2)-VASc-HSF score in single-vessel disease group,double-vessel disease group and multi-vessel disease group increased in turn(P<0.05).Multivariate logistic regression analysis showed that male and elevated CHA_(2)DS_(2)-VASc-HSF score were independent risk factors for coronary heart disease,and elevated fasting plasma glucose and MHR were independent risk factors for coronary artery lesion(P<0.05).ROC curve analysis showed that the best critical value was 0.397 and 1.5 points,combination of the two indexes had the greatest predictive value and area under ROC curve(AUC)was 0.733.MHR and CHA_(2)DS_(2)-VASc-HSF score for predicting severity of coronary artery lesion were 0.587 and 0.642 respectively,combination of the two indexes had the better predictive value and AUC was 0.661.Conclusion MHR and CHA_(2)DS_(2)-VASc-HSF score can be used as valuable predictors of coronary heart disease and severity of coronary artery lesion,and the combination of them is of the great value in predicting coronary heart disease and severity of coronary artery lesion.
作者
孙雪
王虹
梁浩
高海超
肖双
柴立杰
杨拓
Sun Xue;Wang Hong;Liang Hao;Gao Haichao;Xiao Shuang;Chai Lijie;Yang Tuo(Department of Cardiovascular Internal Medicine,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)
出处
《临床内科杂志》
CAS
2022年第2期87-90,共4页
Journal of Clinical Internal Medicine
