LDL-C/Apo B在2型糖尿病并发冠心病中的预测价值及对生存率的影响  

Study on the role of LDL-C/Apo B in the predicting of coronary heart disease complicated with type 2 diabetes mellitus and its effect on the survival rate

作　　者：罗高潮 夏小闯 金朝霞[1] LUO Gaochao;XIA Xiaochuang;JIN Chaoxia(Department of Endocrinology,Huanggang Central Hospital,Huanggang,Hubei 438000,China;Department of Cardiovascular Medicine,Huanggang Central Hospital,Huanggang,Hubei 438000,China)

机构地区：[1]黄冈市中心医院内分泌科,湖北黄冈438000 [2]黄冈市中心医院心血管内科,湖北黄冈438000

出　　处：《检验医学与临床》2024年第24期3605-3610,共6页Laboratory Medicine and Clinic

摘　　要：目的分析低密度脂蛋白胆固醇(LDL-C)/载脂蛋白B(Apo B)(LDL-C/Apo B)对2型糖尿病(T2DM)并发冠心病(CHD)的预测价值及对患者生存率的影响。方法根据纳入、排除标准,选取2017年1月至2018年3月该院收治的332例T2DM患者展开回顾性分析,根据是否并发CHD,将227例T2DM并发CHD患者纳入CHD组,105例T2DM未并发CHD患者纳入非CHD组,比较两组一般资料及脂代谢指标,使用受试者工作特征(ROC)曲线分析LDL-C/Apo B对T2DM并发CHD的预测效能,并获取Cut-off值。对T2DM并发CHD患者进行再分组,以Cut-off值分界点分为低LDL-C/Apo B组与高LDL-C/Apo B组,采用Kaplan-Meier曲线分析患者生存率。结果CHD组与非CHD组一般资料比较,差异均无统计学意义(P>0.05)。与非CHD组比较,CHD组血清LDL-C、Apo B、非HDL-C和甘油三酯水平明显升高,血清HDL-C、HDL-C/非HDL-C、LDL-C/Apo B明显降低,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,LDL-C/Apo B预测T2DM并发CHD的曲线下面积(AUC)为0.752,Cut-off值为1.195(灵敏度:85.71%;特异度:57.20%)。低LDL-C/Apo B组(LDL-C/Apo B<1.195,134例)与高LDL-C/Apo B组(LDL-C/Apo B≥1.195,93例)一般资料比较,差异均无统计学意义(P>0.05);与高LDL-C/Apo B组比较,低LDL-C/Apo B组Apo B明显降低,差异有统计学意义(P<0.05)。低LDL-C/Apo B组生存率为63.78%,低于高LDL-C/Apo B组的78.41%(χ^(2)=5.024,P=0.025)。结论低LDL-C/Apo B与T2DM并发CHD密切相关,LDL-C/Apo B=1.195是预测T2DM并发CHD的分界值,LDL-C/Apo B<1.195的T2DM并发CHD患者具有较低的生存率。Objective To analyze the predictive value of low density lipoprotein cholesterol(LDL-C)/apolipoprotein B ratio(LDL/Apo B)and its effect on the survival rate of type 2 diabetes mellitus(T2DM)complicated with coronary heart disease(CHD)patients.Methods Accoding to indusion and exculusion criteria,332 T2DM patients admitted to Huanggang Central Hospital from January 2017 to March 2018 were selected for this retrospective analysis.Acconding to wheather CHD was concurrent or not,a total of 227 T2DM patients with CHD were included in the CHD group,and 105 T2DM patients without CHD were included in the non CHD group.The general data and lipid metabolism indicators of the two groups were compared.The predictive efficacy of LDL-C/Apo B on T2DM complicated with CHD was analyzed using the receiver operating characteristics(ROC)curve,and the Cut-off value was obtained.Patients with T2DM combined with CHD were further divided into low LDL-C/Apo B group and high LDL-C/Apo B group based on the Cut-off point,Kaplan-Meier curve was used to analyze the survival rate of the patients.Results There was no statistically significant difference in general data between the CHD group and the non CHD group(P>0.05).Compared with the non CHD group,the CHD group showed significant raise in LDL-C,Apo B,non-HDL-C,triglycerides,significant reductions on HDL-C,HDL-C/non-HDL-C and LDL-C/Apo B,with statistically significant differences(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of LDL-C/Apo B predicting for T2DM complicated with CHD was 0.752,and the Cut-off value was 1.195(sensitivity was 85.71%,specificity was 57.20%).There was no statistically significant difference in general data between the low LDL-C/Apo B group(LDL-C/Apo B ratio<1.195,134 cases)and the high LDL-C/Apo B group(LDL-C/Apo B ratio≥1.195 cases,93 cases,P>0.05).Compared with the high LDL-C/Apo B group,the low LDL-C/Apo B group showed a significant decrease in Apo B,and the difference was statistically significant(P<0.05).The survival rate of t

关 键 词：2型糖尿病 冠心病 低密度脂蛋白 载脂蛋白B 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]