血浆致动脉硬化指数与臂-踝脉搏波传导速度在早发冠心病发生及其冠状动脉病变程度中的评估价值  

The value of atherogenic index of plasma and brachial-ankle pulse wave conduction velocity in the development of premature coronary artery disease and the degree of its coronary lesion

作　　者：石宝兰 王红[1] 张向阳[1] SHI Bao-lan;WANG Hong;ZHANG Xiang-yang(Department of Cardiology,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心血管内科,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《中国心血管病研究》2023年第5期422-427,共6页Chinese Journal of Cardiovascular Research

基　　金：新疆维吾尔自治区重点研发专项(2022B03009-2)。

摘　　要：目的探讨血浆致动脉硬化指数(AIP)与臂-踝脉搏波传导速度(ba-PWV)在早发冠心病(PCAD)的发生及其冠状动脉病变程度中的评估价值。方法收集2020年12月至2021年12月因胸痛疑诊冠心病在新疆医科大学第一附属医院住院行冠状动脉造影(CAG)检查且男性<55岁,女性<65岁的患者336例,根据CAG确诊早发冠心病(PCAD)组163例,其中急性冠状动脉综合征92例(56.4%),稳定型冠心病71例(43.6%),未达冠心病诊断标准的173例患者设为对照组。又根据Gensini评分分为A组(0分)129例、B组(1-14分)126例、C组(>14分)81例。对各组间一般临床资料与相关实验室检查进行统计学分析。采用logistic回归模型筛选PCAD的独立危险因素,并进一步分析AIP及ba-PWV对PCAD的诊断价值。结果与对照组相比,PCAD组AIP、ba-PWV等均明显偏高,差异具有统计学意义(P<0.05)。相关分析显示,AIP、ba-PWV与Gensini评分均呈正相关(rs分别为0.321、0.440,均P<0.05)。Logistic多因素回归分析显示,ba-PWV、AIP、吸烟、糖尿病、Hcy等均为PCAD的独立危险因素(均P<0.05);以AIP联合ba-PWV绘制的ROC曲线下面积为0.780(95%CI 0.730~0.830,P<0.05),敏感度和特异度分别为70.60%、77.50%。结论AIP及ba-PWV均为PCAD的独立危险因素,二者联合时可以提高诊断PCAD的敏感度,且二者与冠状动脉病变程度均呈正相关。Objective To investigate the value of atherogenic index of plasma(AIP)and brachial-ankle pulse wave conduction velocity(ba-PWV)in the development of premature coronary artery disease(PCAD)and the degree of coronary lesion.Methods 336 patients who were hospitalized in the First Affiliated Hospital of Xinjiang Medical University for coronary angiography(CAG)due to suspected coronary artery disease with chest pain,with<55 years old in the men and<65 years old in the women.163 patients were diagnosed with premature coronary artery disease(PCAD)according to CAG,including 92 patients with acute coronary syndrome(56.4%),71 patients with stable coronary artery disease(43.6%),and 173 patients who did not meet the criteria for coronary artery disease diagnosis were set as the control group.The patients were further divided into 129 cases in group A(0 points),126 cases in group B(1-14 points),and 81cases in group C(>14 points)according to Gensini score.The general clinical data and relevant laboratory tests were statistically analyzed among the groups.Logistic regression models were used to screen independent risk factors for PCAD,and the diagnosis value of AIP and ba-PWV for the PCAD was further analyzed.Results Compared with the control group,both AIP and ba-PWV were significantly higher in the PCAD group,and the difference was statistically significant(P<0.05).Correlation analysis showed that both AIP and ba-PWV were positively correlated to Gensini score(rs 0.321 and 0.440,respectively,P<0.05 both).Logistic multi-factor regression analysis showed that ba-PWV,AIP,smoking,diabetes,and Hcy were the independent risk factors for PCAD(all P<0.05).The area under the ROC curve plotted with AIP combined with ba-PWV was 0.780(95%CI 0.730-0.830),and the sensitivity and specificity were 70.60%and 77.50%.Conclusions Both AIP and ba-PWV are the independent predictors of PCAD,and when combined,they can improve the sensitivity of diagnosing PCAD.

关 键 词：血浆致动脉硬化指数 臂-踝脉搏波传导速度 早发冠心病 动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]