富含三酰甘油的脂蛋白胆固醇对老年患者冠状动脉病变的预测及评估价值分析  

Prediction of triglyceride-rich lipoprotein cholesterol for coronary artery lesions in elderly patients and evaluation of its predictive value

作　　者：齐炜[1] 丛洪良 Qi Wei;Cong Hongliang(Department of Cardiology,Tianjin Institute of Cardiovascular Diseases,Tianjin Chest Hospital,Tianjin University,Tianjin 300222,China)

机构地区：[1]天津大学胸科医院心内科,天津市心血管病研究所,300222

出　　处：《中华老年心脑血管病杂志》2024年第5期527-530,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：天津市医学重点学科建设项目(TJYXZDXK-055B)。

摘　　要：目的探讨富含三酰甘油的脂蛋白胆固醇(TRL-C)水平与老年冠心病患者冠状动脉病变严重程度的相关性。方法选择2020年1月1日至2020年12月31日在天津市胸科医院就诊并行冠状动脉造影检查的老年冠心病患者220例,根据SYNTAX评分将患者分为轻度冠状动脉病变组158例(1~22分)和中重度冠状动脉病变组62例(≥23分)。用logistic回归分析和ROC曲线分析。结果与轻度冠状动脉病变组比较,中重度冠状动脉病变组白蛋白、载脂蛋白A、血小板计数显著降低,肌钙蛋白T、N末端B型钠尿肽前体、TRL-C显著升高(P<0.05,P<0.01)。多因素logistic回归分析显示,TRL-C是冠状动脉病变的危险因素(OR=4.450,95%CI:1.572~12.599,P=0.005),白蛋白是冠状动脉病变的保护因素(OR=0.880,95%CI:0.794~0.977,P=0.016)。ROC曲线分析显示,TRL-C诊断中重度冠状动脉病变的曲线下面积为0.655(95%CI:0.580~0.731)。结论TRL-C对我国老年冠心病患者的冠状动脉病变严重程度具有预测价值,对中重度冠状动脉病变有一定评估价值。Objective To investigate the correlation between triacylglycerol-rich lipoprotein cholesterol(TRL-C)level and the severity of coronary artery disease in elderly patients with coronary heart disease(CHD).Methods A total of 220elderly CHD patients who underwent coronary angiography in our hospital from January 1to December 31,2020were enrolled in this study.They were divided into mild coronary artery disease group(SYNTAX score 1-22,158cases)and moderate to severe coronary artery disease group(SYNTAX score≥23,62cases).Logistic regression analysis and ROC curve analysis were used.Results Compared with the mild coronary artery disease group,the moderate and severe coronary artery disease group had significantly lower albumin,apolipoprotein(Apo)A and platelet count,while increased cTnT,NT-proBNP and TRL-C levels(P<0.05,P<0.01).Multivariate logistic regression analysis showed that TRL-C was a risk factor(OR=4.450,95%CI:1.572-12.599,P=0.005),while albumin was a protective factor for coronary artery disease(OR=0.880,95%CI:0.794-0.977,P=0.016).ROC curve analysis indicated that the AUC value of TRL-C for diagnosing moderate to severe coronary lesions was 0.655(95%CI:0.580-0.731).Conclusion TRL-C has a predictive value for the severity of coronary artery disease in elderly CHD patients,and has a predictive value for moderate to severe coronary artery disease.

关 键 词：冠状动脉疾病 脂蛋白类 预测 LOGISTIC模型 富含三酰甘油的脂蛋白胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]