皮肤胆固醇测定联合心电图平板运动对不典型胸痛患者冠心病诊断分析  

Analysis of skin cholesterol determination combined with ECG treadmill exercise in diagnosis of coronary heart disease in patients with atypical chest pain

作　　者：杜坤[1] 陈文韬[2] 鞠晓玲 汪洁[1] DU Kun;CHEN Wentao;JU Xiaoling;WANG Jie(Department of Dermatology,Ezhou Central Hospital,Ezhou 436000,China;不详)

机构地区：[1]鄂州市中心医院皮肤科,湖北鄂州436099 [2]鄂州市中心医院心内科,湖北鄂州436099 [3]鄂州市中医医院皮肤科,湖北鄂州436099

出　　处：《实用医学杂志》2023年第20期2671-2675,共5页The Journal of Practical Medicine

摘　　要：目的利用皮肤胆固醇无创检测系统检测不典型胸痛患者的皮肤胆固醇含量,联合心电图平板运动(EET),探索皮肤胆固醇含量与EET对不典型胸痛患者冠心病的临床预测价值。方法2020年4月至2021年4月鄂州市中心医院收治的不典型胸痛患者128例,所有患者入院前1个月内均未服用任何降脂药物、抗心肌缺血药物,住院期间完成皮肤胆固醇含量检测、EET检查、冠脉造影、评估Gensini评分、病变血管数目。根据冠脉造影结果分为冠心病组、非冠心病组,分析两组患者的一般临床资料、皮肤胆固醇含量、EET结果。就皮肤胆固醇含量与Gensini评分进行相关性分析。应用多因素logistic回归筛选对不典型胸痛患者诊断冠心病有预测价值的因素。结果皮肤胆固醇含量在冠心病患者中明显升高、随着冠脉病变支数的增多,皮肤胆固醇含量也显著增多。皮肤胆固醇含量与Gensini评分呈正相关。Logistic回归分析显示:皮肤胆固醇含量、EET阳性为冠心病的预测因素。皮肤胆固醇含量、EET预测不典型胸痛患者确诊冠心病的ROC曲线下面积为0.879、0.617,灵敏度分别为86.2%、67.3%,特异度分别为74.3%、49.3%,两者联合预测不典型胸痛患者确诊冠心病的曲线下面积为0.917,灵敏度、特异度分别为91.5%、82.3%。结论皮肤胆固醇含量对不典型胸痛患者诊断冠心病有良好价值,联合EET能进一步提高诊断的灵敏度和特异度。Objective To explore the clinical predictive value of skin cholesterol and electrocardiogram treadmill exercise(EET)for coronary heart disease(CHD)in patients with atypical chest pain.Methods One hundred and twenty-eight patients with atypical chest pain admitted from April 2020 to April 2021 were enrolled.All patients did not take any lipid-lowering drugs or anti-myocardial ischemia drugs within 1 month before admission.Skin cholesterol content test,EET test,coronary angiography,Gensini score and number of diseased vessels were completed during hospitalization.According to the results of coronary angiography,the patients were divided into CHD group and non-CHD group.General clinical data,skin cholesterol content and EET results of the two groups were analyzed.Correlation analysis was performed between skin cholesterol content and Gensini score.Multivariate logistic regression was used to screen factors with predictive value for the diagnosis of CHD in patients with atypical chest pain.Results The content of cholesterol in skin increased significantly in patients with CHD.With the increase of the number of coronary artery lesions,the content of cholesterol in skin also increased significantly.Skin cholesterol content was positively correlated with Gensini score.Logistic regression analysis showed that skin cholesterol content and EET positive were predictors of CHD.The area under ROC curve of skin cholesterol content and EET in predicting the diagnosis of CHD in patients with atypical chest pain was 0.879 and 0.617,the corresponding sensitivity 86.2%and 67.3%,and the specificity 74.3%and 49.3%,respectively.The area under ROC curve of the combination of the two in predicting the diagnosis of CHD in patients with atypical chest pain was 0.917,and the sensitivity and specificity were 91.5%and 82.3%,respectively.Conclusion Skin cholesterol content is of good value in the diagnosis of CHD in patients with atypical chest pain,and EET can further improve the sensitivity and specificity of diagnosis.

关 键 词：皮肤胆固醇 冠心病 曲线下面积 

分 类 号：R446.19[医药卫生—诊断学] R447[医药卫生—临床医学]