摘要
目的探讨甘油三酯-葡萄糖指数(TyG指数)联合低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比率(LDL-C/HDL-C)对急性冠状动脉综合征(ACS)及冠状动脉病变程度的预测价值。方法回顾性分析2020年9月至2023年9月因胸闷和胸痛入住合肥市第二人民医院心内科并接受冠状动脉造影(CAG)检查的245例患者的临床资料,将诊断为ACS的患者设为ACS组(n=204)、同期经CAG排除冠心病的患者设为正常组(n=41),通过Gensini评分进一步将ACS组分为两个亚组,冠状动脉轻中度病变亚组(Gensini评分<35分)64例和冠状动脉重度病变亚组(Gensini评分≥35分)140例。比较ACS组和正常组TyG指数、LDL-C/HDL-C比率等指标;比较冠状动脉重度病变亚组和冠状动脉轻中度病变亚组TyG指数、LDL-C/HDL-C比率等指标。分析ACS及ACS患者冠状动脉重度病变的影响因素。分析TyG指数和LDL-C/HDL-C与Gensini评分的相关性;ROC曲线分析评估TyG指数联合LDL-C/HDL-C比率诊断ACS及ACS患者发生冠状动脉重度病变的价值。结果多因素Logistic回归分析显示,TyG指数、LDL-C/HDL-C比率均为ACS及ACS患者冠状动脉重度病变的独立危险因素(P<0.01)。Pearson相关性分析结果表明,TyG指数、LDL-C/HDL-C比率与ACS患者的Gensini评分呈正相关(r=0.390,P<0.01;r=0.396,P<0.01)。ROC曲线分析,TvG指数、LDL-C/HDL-C比率以及二者联合诊断ACS的AUC为0.788、0.797、0.843(P<0.01),诊断冠状动脉重度病变的AUC为0.753、0.765、0.817(P<0.01)。结论TyG指数及LDL-C/HDL-C比率的升高对ACS及ACS患者冠状动脉重度病变具有一定的诊断价值,且二者联合的诊断价值优于任一单项指标,对ACS的识别以及预测ACS患者冠状动脉重度病变有一定临床价值。
Objective To investigate the predictive value of triglyceride-glucose index(TyG index)combined with low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C)for acute coronary syndromes(ACS)and the degree of coronary artery lesions.Methods The clinical data of 245 patients who were admitted to the Department of Cardiology of the Second People’s Hospital of Hefei City and underwent coronary angiography(CAG)due to chest tightness and chest pain from September 2020 to September 2023 were retrospectively analyzed;the patients diagnosed with ACS were set up as the ACS group(n=204),but the patients with coronary heart disease excluded by coronary angiography during the same period were set up as the normal group(n=41);and the ACS group was further divided into two subgroups by the Gensini score,with 64 cases in the subgroup of mild-to-moderate coronary artery lesions(Gensini score<35)and 140 cases in the subgroup of severe coronary artery lesions(Gensini score≥35).The TyG index and LDL-C/HDL-C ratio were compared between the ACS group and the normal group;the TyG index and LDL-C/HDL-C ratio were compared between the subgroup with severe coronary lesions and the subgroup with mild to moderate coronary lesions.The multifactorial Logistic regression analysis was used to analyze the influencing factors of ACS and ACS patients with severe coronary lesions.The Pearson correlation analysis was used to analyze the correlation between TyG index and LDL-C/HDL-C and Gensini score.ROC curve analysis was performed to assess the value of TyG index combined with LDL-C/HDL-C ratio in diagnosing the occurrence of severe coronary lesions in ACS and ACS patients.Results The multifactorial Logistic regression analysis showed that both TyG index and LDL-C/HDL-C ratio were the independent risk factors for severe coronary artery lesions in ACS and ACS patients(P<0.01).The Pearson correlation analysis showed that there was a positive correlation between TyG index and LDL-C/HDL-C ratio and the Gensini score in ACS patients(r=0.390,P<0.01;r=0.396,P<0.01).ROC curve analysis showed that the AUCs of TvG index,LDL-C/HDL-C ratio and the combination of the two for diagnosis of ACS were 0.788,0.797 and 0.843(P<0.01),and those for diagnosis of severe coronary artery lesions were 0.753,0.765,and 0.817(P<0.01).Conclusion Elevated TyG index and LDL-C/HDL-C ratio have certain diagnostic value for ACS and severe coronary artery lesions in ACS patients,and the combined diagnostic value of the two is better than that of either single index,which is of clinical value for the identification of ACS and the prediction of severe coronary artery lesions in ACS patients.
作者
李雪雅
温祥
杨力
杨煜
经纬
张静
LI Xue-ya;WEN Xiang;YANG Li;YANG Yu;JING Wei;ZHANG Jing(Department of Cardiovascular,Heifei Hospital of Anuhui Medical University Hefei Second People’s Hospital,Hefei 230011,China)
出处
《中国心血管病研究》
2025年第1期15-21,共7页
Chinese Journal of Cardiovascular Research
基金
2021年安徽省重点研究与开发计划(第一批)[202104j07020058]。
