血清甲状旁腺激素/HDL-C及LDL-C/HDL-C与冠状动脉病变严重程度的相关性  

Correlation between serum PTH/HDL-C and LDL-C/HDL-C and severity of coronary artery disease

作　　者：刘叶红 靳天慧 陈亮[1,2] 徐佰达[1,2] 叶挺 吴刚勇[1,2] 宗刚军 LIU Yehong;JIN Tianhui;CHEN Liang;XU Baida;YE Ting;WU Gangyong;ZONG Gangjun(Wuxi Clinical College of Anhui Medical University,Wuxi,Jiangsu,214000,China;Department of Cardiology,904 Joint Logistic Support Force Hospital of the Chinese People's Liberation Army)

机构地区：[1]安徽医科大学无锡临床学院,江苏无锡214000 [2]中国人民解放军联勤保障部队第904医院心内科

出　　处：《临床心血管病杂志》2020年第11期985-990,共6页Journal of Clinical Cardiology

基　　金：江苏省青年医学人才基金(No:QNRC2016883)。

摘　　要：目的:探讨甲状旁腺激素(PTH)/HDL-C、LDL-C/HDL-C在冠状动脉(冠脉)病变严重程度中的预测价值。方法:380例患者接受了冠脉造影,其中对照组为87例冠脉正常患者,其余293例冠心病患者根据Gensini评分分为轻度狭窄组(1~30分)130例与重度狭窄组(≥30分)163例。检测各组患者行冠脉造影前外周血PTH、TC、TG、HDL-C、LDL-C等生化指标,计算PTH/HDL-C及LDL-C/HDL-C并进行统计分析。结果:(1)在冠脉重度狭窄组中PTH、PTH/HDL-C、LDL-C/HDL-C水平显著高于轻度狭窄组及对照组,差异有统计学意义(P<0.05)。(2)相关性分析显示,PTH、PTH/HDL-C、LDL-C/HDL-C与冠脉病变严重程度呈正相关。(3)多因素Logistic回归分析显示,糖尿病史、吸烟史、PTH/HDL-C、LDL-C/HDL-C、LP(a)是冠脉重度狭窄的独立危险因素。(4)受试者工作特征曲线显示,PTH/HDL-C对重度冠脉狭窄的预测能力明显优于PTH、LDL-C/HDL-C两个指标。结论:PTH/HDL-C及LDL-C/HDL-C是冠脉重度狭窄的独立危险因素,且PTH/HDL-C及LDL-C/HDL-C与冠脉病变的严重程度呈正相关,PTH/HDL-C相比LDL-C/HDL-C对重度冠脉狭窄有更好的预测价值。Objective: To investigate the predictive value of PTH/HDL and LDL/HDL in the severity of coronary artery disease. Method: In the study, 380 patients underwent coronary angiography. The control group included 87 patients with normal coronary artery. The remaining CAD patients were divided into two groups according to Gensini score, as 130 patients in the mild disease group(1-30 points) and 163 patients in the severe disease group(≥30 points). PTH, TC, TG, HDL-C, LDL-C and other biochemical indexes were detected before coronary angiography. Result:(1) The levels of PTH, PTH/HDL-C and LDL-C/HDL-C in the severe coronary artery disease group were significantly higher than those in the mild coronary artery disease group and the control group, and the differences were statistically significant(P<0.05).(2) PTH, PTH/HDL-C, LDL-C/HDL-C were positively correlated with the severity of coronary artery disease.(3) Multivariate Logistic regression analysis showed that diabetes history, smoking history, PTH/HDL-C, LDL-C/HDL-C, LP(a) were independent risk factors for severe coronary stenosis.(4) The receiver operating characteristic curve(ROC curve) showed that the prediction ability of PTH/HDL-C for severe coronary stenosis was significantly better than that of PTH and LDL-C/HDL-C. Conclusion: PTH/HDL-C and LDL-C/HDL-C are independent risk factors for severe coronary artery stenosis, and PTH/HDL-C and LDL-C/HDL-C are positively correlated with the severity of coronary artery disease. Compared with LDL-C/HDL-C, PTH/HDL-C has better predictive value for severe coronary artery stenosis, which has certain guiding significance in clinical practice.

关 键 词：冠状动脉狭窄 甲状旁腺激素 低密度脂蛋白胆固醇 高密度脂蛋白胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]