低密度脂蛋白、碱性磷酸酶联合颈动脉超声对冠状动脉粥样硬化性心脏病的预测价值  

Predictive value of low density lipoprotein and alkaline phosphatase combined with carotid ultrasound in coronary atherosclerotic heart disease

作　　者：吴宇红[1] 周艺[1] 谭艳艳 WU Yuhong;ZHOU Yi;TAN Yanyan(Health Management Center,Jiangmen Central Hospital,Guangdong Province,Jiangmen 529030,China)

机构地区：[1]广东省江门市中心医院健康管理中心,广东江门529030

出　　处：《中国当代医药》2024年第21期46-49,54,共5页China Modern Medicine

基　　金：广东省江门市科技计划项目(2022YL01022)。

摘　　要：目的利用低密度脂蛋白(LDL)、碱性磷酸酶(ALP)联合颈动脉超声的方法,预测冠状动脉粥样硬化性心脏病(CHD)发生风险。方法选取2020年1月至2022年12月江门市中心医院收治的105例CHD患者为研究对象,另选取105例非CHD患者作为对照组,两组均行颈动脉超声检查,观察两组LDL、ALP及颈动脉超声指标的差异。采用logistic回归分析CHD的影响因素,通过ROC曲线分析LDL、ALP联合颈动脉超声对CHD风险的预测价值。结果单因素分析结果显示,CHD与双侧颈动脉斑块平均厚度(avr_CIMT)、左侧颈动脉斑块内膜中层厚度(LCIMT)、右侧颈动脉斑块内膜中层厚度(RCIMT)、左侧颈动脉斑块长度(LCPL)、左侧颈动脉斑块乘积(LCPT)、左侧颈动脉斑块厚度(LCPH)、右侧颈动脉斑块长度(RCPL)、右侧颈动脉斑块乘积(RCPT)、右侧颈动脉斑块厚度(RCPH)、双侧颈动脉斑块最大厚度(max_CPH)、双侧颈动脉斑块最大长度(max_CPL)、双侧颈动脉斑块积分(cPS)、ALP、手术风险评分(SRS)、Framingham风险评分(FRS)、LDL有关,差异有统计学意义(P<0.05);logistic回归模型进行多因素分析结果显示,max_CPH(β=0.009,OR=1.981,95%CI:0.882~1.987),max_CPL(β=0.342,OR=2.241,95%CI:0.098~2.901),cPS(β=0.456,OR=1.521,95%CI:0.501~1.554),avr_CIMT(β=0.320,OR=0.784,95%CI:0.523~0.967),LDL(β=0.152,OR=2.431,95%CI:0.386~2.450),ALP(β=0.254,OR=1.324,95%CI:0.230~2.412)是CHD的独立危险因素(P<0.05)。结论利用LDL、ALP联合颈动脉超声的方法,可提高对CHD患者发生的预测效能。Objective To predict the risk of coronary atherosclerotic heart disease(CHD)by using low density lipoprotein(LDL)and alkaline phosphatase(ALP)combined with carotid ultrasound.Methods A total of 105 patients with CHD admit-ted to the Jiangmen Central Hospital from January 2020 to December 2022 were collected as research objects,and 105 pa-tients without CHD were selected as the control group.Carotid artery ultrasound examination was performed in both groups to observe the differences of LDL,ALP and carotid artery ultrasound indexes between the two groups.The influence factors of CHD were analyzed by binary logistic regression,and the predictive value of LDL and ALP combined with carotid artery ultrasound for CHD risk was analyzed by ROC curve.Results The results of single factor analysis showed that CHD was as-sociated with bilateral carotid intima-media thickness(avr_CIMT),left carotid intima-media thickness(LCIMT),right carotid intima-media thickness(RCIMT),left carotid plaque length(LCPL),left carotid plaque product(LCPT),left carotid plaque thickness(LCPH),and right carotid plaque length(RCPL),right carotid plaque product(RCPT),right carotid plaque thickness(RCPH),maximum bilateral carotid plaque thickness(max_CPH),maximum bilateral carotid plaque length(max_CPL),bilateral carotid plaque score(cPS),ALP,surgical risk score(SRS),Framingham risk score(FRS),LDL and ALP were related,and the difference was statistically significant(P<0.05).Multivariate analysis of logistic regression model showed that max_CPH(β=0.009,OR=1.981,95%CI:0.882-1.987),max_CPL(β=0.342,OR=2.241,95%CI:0.098-2.901),cPS(β=0.456,0R=1.521,95%CI:0.501-1.554),avr_CIMT(β=0.320,OR=0.784,95%CI:0.523-0.967),LDL(β=0.152,OR=2.431,95%CI:0.386-2.450),ALP(β=0.254,0R=1.324,95%CI:0.230-2.412)were independent risk factors for CHD(P<0.05).Conclusion The use of LDL and ALP combined with carotid artery ultrasound can improve the predictive efficiency of CHD.

关 键 词：低密度脂蛋白 碱性磷酸酶 颈动脉超声 冠状动脉粥样硬化性心脏病 

分 类 号：R541[医药卫生—心血管疾病]