血脂异常对不稳定型心绞痛和急性心肌梗死患者临床识别的价值研究  

Value of dyslipidemia to clinical identification in patients with unstable angina pectoris and acute myocardial infarction

作　　者：赵瑛 徐红新[1,2,3] 吕永楠[1,2,3] 周易[1,2,3] 易欣[1,2,3] Zhao Ying;Xu Hongxin;Lyu Yongnan;Zhou Yi;Yi Xin(Department of Cardiovascular Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,China.)

机构地区：[1]武汉大学人民医院心血管内科,武汉430060 [2]武汉大学心血管病研究所,武汉430060 [3]武汉大学心血管病湖北省重点实验室,武汉430060

出　　处：《中国循证心血管医学杂志》2020年第6期720-722,727,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：湖北省自然科学基项目(2018CFB752)。

摘　　要：目的 探讨血脂异常对不稳定型心绞痛(UAP)和急性心肌梗死(AMI)患者临床识别的价值和意义.方法 本研究纳入武汉大学人民医院于2016年1月至2018年12月收治的UAP患者122例、AMI患者185例.采用全自动生化分析仪检测所有患者血清中三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、心肌肌钙蛋白I(cTnI)等.ROC曲线分析观察血脂指标联合或单独检测对UAP和AMI患者临床识别的敏感性和特异性.结果 Mann-Whitney U检验结果显示AMI患者血清中血糖值Glu、脑钠肽前体(proBNP)、cTnI显著高于UAP组患者,差异具有统计学意义(P<0.05);Unpaired studentt检验结果显示AMI患者血清中TC、LDL-C、纤维蛋白原(FIB)的水平显著高于UAP组患者,差异具有统计学意义(P<0.05).ROC曲线分析TC、LDL-C的曲线下面积分别为0.623和0.654,而TC联合LDL-C的曲线下面积仅占0.664.结论 血脂指标TC联合LDL-C对于临床识别UAP和AMI的诊断价值不大.因此,血脂指标异常仅只能作为UAP和AMI患者的辅助诊断之一,临床早期鉴别诊断两者尚需借助其他检查手段.Objective To discuss the value and significance of dyslipidemia to clinical identification in patients with unstable angina pectoris(UAP)and acute myocardial infarction(AMI).Methods UAP patients(UAP group,n=122)and AMI patients(AMI group,n=185)were chosen from Renmin Hospital of Wuhan University from Jan.2016 to Dec.2018.The levels of triglyceride(TG),total cholesterol(TC),high-density lipoprotein-cholesterol(HDL-C),low-density lipoprotein-cholesterol(LDL-C)and cardiac troponin I(cTnI)were detected by using automatic biochemical analyzer in 2 groups.The sensitivity and specificity of combined or alone detections of blood fat indexes were observed through ROC curve analysis in 2 groups.Results The results of Mann-Whitney U test showed that the levels of plasma glucose,pro-brain natriuretic peptide(proBNP)and cTnI were significantly higher in AMI group than those in UAP group(P<0.05).The results of unpaired student test showed that the levels of TC,LDL-C and FIB were significantly higher in AMI group than those in UAP group(P<0.05).The results of ROC curve analysis showed that the area under curve(AUC)of TC was 0.623,AUC of LDL-C was 0.654,and AUC of TC combined LDL-C was 0.664.Conclusion TC combined with LDL is of little value in clinical identification of UAP and AMI.Therefore,abnormal blood fat indexes can only be used as one of auxiliary diagnoses in UAP and AMI patients.The early identification and diagnosis of UAP and AMI need other means.

关 键 词：血脂异常 不稳定心绞痛 急性心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]