心脏瓣膜钙化影响因素的分析  

Influencing factors of cardiac valve calcification

作　　者：彭泰峦[1] 陈思含 张静秋[1] 张宁[1] 向军[1] 魏蜀亮[1] PENG Tailuan;CHEN Sihan;ZHANG Jingqiu;ZHANG Ning;XIANG Jun;WEI Shuliang(Department of Cardiovascular Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan,637000,China;Department of Breast and Thyroid Surgery,Affiliated Hospital of North Sichuan Medical College)

机构地区：[1]川北医学院附属医院心脏大血管外科,四川南充637000 [2]川北医学院附属医院甲状腺乳腺外科

出　　处：《临床心血管病杂志》2023年第12期962-967,共6页Journal of Clinical Cardiology

基　　金：四川省南充市科技局合作科研项目(No:22SXQT0007)。

摘　　要：目的:探讨心脏瓣膜钙化的影响因素,为术前评估瓣膜钙化提供参考指标。方法:该研究为病例对照单中心回顾性分析,根据川北医学院附属医院信息中心数据库收集2021年1月—2022年1月川北医学院附属医院心脏大血管外科的心脏瓣膜疾病患者的信息,参照纳入及排除标准,共236例患者入组。记录患者游离脂肪酸(FFA)、冠心病、高血压、糖尿病等一般情况。采用Spearman秩相关分析瓣膜钙化与临床指标相关性,采用多因素logistic回归分析瓣膜钙化的独立危险因素,运用受试者工作特征(ROC)曲线评价各影响因素对瓣膜钙化的诊断意义。结果:对比两组患者的年龄、FFA水平、射血分数、心功能分级、吸烟情况、冠心病、心房颤动、高血压以及糖尿病,差异具有统计学意义(P<0.05)。Spearman秩相关分析显示瓣膜钙化程度与FFA水平、冠心病、糖尿病呈正相关(P<0.05)。多因素logistic回归分析显示年龄(OR=1.029,95%CI 1.002~1.058,P=0.037)、FFA(OR=1.244,95%CI 1.027~1.506,P=0.025)、冠心病(OR=2.414,95%CI 1.029~5.662,P=0.043)、糖尿病(OR=4.490,95%CI 1.838~10.972,P=0.001)是瓣膜钙化独立影响因素。ROC曲线分析显示FFA、年龄、冠心病、糖尿病诊断瓣膜钙化的AUC分别为0.783、0.689、0.723、0.687,而4者联合诊断的曲线下面积(AUC)为0.858。结论:FFA联合年龄、冠心病、糖尿病等相关因素,对心脏瓣膜钙化具有一定的诊断价值。Objective To explore the influencing factors of heart valve calcification and provide reference indicators for preoperative assessment of valve calcification.Methods This study is a case-control single-center retrospective analysis. According to the database of the Information Center of the Affiliated Hospital of North Sichuan Medical College, the information of patients with heart valve disease was collected. Based on the inclusion and exclusion criteria, a total of 236 patients were enrolled. Obtaining patient information, including free fatty acid(FFA), coronary heart disease, hypertension, and diabetes, etc. Spearman rank correlation was used to analyze the correlation between heart valve calcification and clinical indicators. Multi-factor logistic regression was used to analyze the independent risk factors of valve calcification, and the receiver operating characteristic(ROC) curve was used to evaluate the diagnostic significance of each influencing factor on valve calcification.Results The differences were statistically significant in age, FFA level, EF value, cardiac function classification, smoking status, coronary heart disease, atrial fibrillation, hypertension and diabetes between the two groups(P < 0.05). Spearman rank correlation analysis showed that the degree of valve calcification was positively correlated with FFA levels, coronary heart disease, and diabetes(P < 0.05). Multivariate logistic regression analysis showed that age(OR=1.029, 95%CI 1.002-1.058, P=0.037), FFA(OR=1.244, 95%CI 1.027-1.506, P=0.025), coronary heart disease(OR=2.414, 95%CI 1.029-5.662, P=0.043), diabetes(OR=4.490, 95%CI 1.838-10.972, P=0.001) are independent influent factors in valve calcification. ROC curve analysis showed that the area under the curve(AUC) for the diagnosis of valve calcification by FFA, age, coronary heart disease, and diabetes were 0.783, 0.689, 0.723, and 0.687 respectively, while the AUC for the combined four factors was 0.858.Conclusion FFA, combines with age, coronary heart disease, diabetes has cert

关 键 词：游离脂肪酸 心脏瓣膜病 心脏瓣膜钙化 相关性 

分 类 号：R541.3[医药卫生—心血管疾病]