胱抑素C、心率减速力、CHADS2衍生评分对冠心病病变程度的预测价值  

Predictive values of cystatin C,heart rate deceleration capacity,and CHADS2 derivative score for severity of coronary heart disease

作　　者：李娜[1] 巫庆荣[1] 张峥[1] 何磊[1] Li Na;Wu Qingrong;Zhang Zheng;He Lei(Department of Emergency Medicine,Zhengzhou People’s Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州人民医院急诊科,河南郑州450000

出　　处：《中华生物医学工程杂志》2019年第6期786-790,共5页Chinese Journal of Biomedical Engineering

摘　　要：目的分析胱抑素C(CysC)、心率减速力(DC)、CHADS2衍生评分(CHA2DS2-VASc-HSF评分)对冠心病(CHD)病变程度的预测价值。方法选择2016年5月至2019年5月郑州人民医院82例CHD患者(CHD组),根据病情将其分为稳定性心绞痛(SAP)组(n=32)、不稳定心绞痛(UAP)组(n=27)及急性心肌梗死(AMI)组(n=23)3个亚组;将同期无心血管疾病的30例体检者纳入对照组。比较CHD组与对照组及CHD组各亚组间受试者血清CysC水平、DC值及CHA2DS2-VASc-HSF评分差异,应用受试者工作特征曲线(ROC)评价血清CysC水平、DC值及CHA2DS2-VASc-HSF评分及三者联合对CHD病变程度的预测价值。结果CHD组血清CysC水平、CHA2DS2-VASc-HSF评分高于对照组(均P<0.05),DC值低于对照组(均P<0.05)。血清CysC水平、DC值及CHA2DS2-VASc-HSF评分与受试者是否患CHD密切相关(P<0.05)。血清CysC水平ROC显示AUC 0.884(P<0.05),临界值为1.14 mg/L,敏感性、特异性分别为72%、90%。DC值ROC显示AUC 0.805(P<0.05),临界值为4.23 ms,敏感性、特异性分别为59.8%、90%。CHA2DS2-VASc-HSF评分ROC显示AUC 0.821(P<0.05),临界值为2.55分,敏感性、特异性分别为68.3%、86.7%。三者联合预测AUC为0.948,敏感度、特异度分别为86.6%、90%,优于各自单独预测(均P<0.05)。血清CysC水平、CHA2DS2-VASc-HSF评分SAP组低于UAP组、AMI组,UAP组低于AMI组(P<0.05);DC值SAP组高于UAP组、AMI组,UAP组高于AMI组(均P<0.05)。结论血清CysC水平、CHA2DS2-VASc-HSF评分升高及DC值降低与CHD发生、进展密切相关,联合检测对CHD诊断及其病情严重程度评估有一定价值。Objective To analyze the predictive values of Cystatin C(CysC),heart rate deceleration capacity(DC)and CHADS2-derived score(CHA2DS2-VASc-HSF score)for severity of coronary heart disease(CHD).Methods Included in this study were 82 CHD patients(CHD group)admitted to Zhengzhou People’s Hospital between May 2016 and May 2019 who were divided into the stable angina pectoris(SAP)subgroup(n=32),unstable angina pectoris(UAP)subgroup(n=27)and acute myocardial infarction(AMI)subgroup(n=23).A contemporary cohort of 30 health checkup recipients without cardiovascular disease were included as the control group.The serum CysC level,DC value and CHA2DS2-VASc-HSF score were compared among the CHD subgroups,as well as between the CHD group and control group.Receiver operating characteristic curve(ROC)was used to evaluate the predictive values of serum CysC level,DC value and CHA2DS2-VASc-HSF score alone or in combination,for severity of CHD.Results The serum CysC level and CHA2DS2-VASc-HSF score were higher(all P<0.05),while the DC value was lower,in CHD group than those in control group(all P<0.05).Serum CysC level,DC value and CHA2DS2-VASc-HSF score were closely related to presence of CHD in the subjects(P<0.05).The area under ROC curve(AUC)of serum CysC level was 0.884,with a cut-off value of 1.14 mg/L,a sensitivity of 72%and a specificity of 90%,respectively.The AUC of DC was 0.805,with a cut-off value of 4.23 ms,a sensitivity of 59.8%and a specificity of 90%,respectively.The AUC of CHA2DS2-VASc-HSF score was 0.821,with a cut-off value of 2.55,a sensitivity of 68.3%and a specificity of 86.7%,respectively.The AUC of the three indicators in combination was 0.948,with a sensitivity of 86.6%and a specificity of 90%,showing advantages in the prediction over each indicator alone(all P<0.05).The serum CysC level and CHA2DS2-VASc-HSF score were lower in SAP subgroup than those in UAP and AMI subgroups;so were in UAP subgroup than those in AMI subgroup(all P<0.05).The DC value was higher in SAP sub group than those in UAP and AMI su

关 键 词：冠心病 胱抑素C 心率减速力 CHADS2衍生评分 预测价值 

分 类 号：R541[医药卫生—心血管疾病]