冠心病患者血尿素氮与血清白蛋白比值与颈动脉斑块的相关性研究  

Association between Blood Urea Nitrogen to Serum Albumin Ratio and Carotid Plaque in Patients with Coronary Heart Disease

作　　者：绳菁煜 刘凡凡 马梅 田霖 刘雨桐 刘凤敏 高杉[1] 于春泉[1] SHENG Jingyu;LIU Fanfan;MA Mei;TIAN Lin;LIU Yutong;LIU Fengmin;GAO Shan;YU Chunquan(Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学,天津市301617

出　　处：《中国全科医学》2025年第15期1831-1839,共9页Chinese General Practice

基　　金：国家自然科学基金面上项目(82074140);天津宏仁堂药业有限公司横向课题(HX2020-16);国家中医药管理局—中医预防医学重点学科建设项目(zyyzdxk-2023008)。

摘　　要：背景血尿素氮(BUN)与血清白蛋白(ALB)比值(BAR)是一种新兴的生物标志物,近年来被认为与多种心肺系统疾病的不良结局相关,但冠心病(CHD)患者的BAR与颈动脉斑块之间的关系目前尚不明确。目的探讨CHD患者BAR与颈动脉斑块之间的相关性。方法回顾性选取2014年1月—2019年9月天津市6家医院住院的CHD患者入院数据。BAR通过BUN/ALB计算。采用Logistic回归分析,评估CHD患者BAR与颈动脉斑块发生风险、斑块数量和斑块性质之间的相关性,并在校正混杂因素后行进一步分析。绘制BAR诊断颈动脉斑块发生风险的受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)。结果共纳入10808例CHD患者数据。其中8158例患有颈动脉斑块,颈动脉斑块患病率为75.5%。将10808例CHD患者数据按BAR的四分位数(Q1、Q2、Q3、Q4)分为4组。Q1组BAR≤-0.3954,-0.3954<Q2组BAR≤-0.1587,-0.1587<Q3组BAR≤0.1324,Q4组BAR>0.1324。与Q1组相比,经过多变量调整后,Q4组的BAR与颈动脉斑块形成的相关性最强(OR=1.512,95%CI=1.273~1.795,P<0.001)。CHD患者BAR诊断颈动脉斑块发生风险的AUC为0.612(95%CI=0.600~0.624)。女性群体中BAR水平与斑块之间有较强的相关性(OR=1.583,95%CI=1.260~1.989,P<0.001),老年群体中BAR与斑块之间有较强的相关性(OR=1.810,95%CI=1.459~2.246,P<0.001)。且BAR与颈动脉斑块的相关性不受高血压、高脂血症、糖尿病等疾病的影响。结论高水平的BAR与颈动脉斑块形成相关,且在女性、中老年人群中更显著。BAR升高可能有助于早期识别CHD患者颈动脉斑块的形成,从而避免主要不良心血管事件的发生。Background The ratio of blood urea nitrogen(BUN)to serum albumin(ALB)(BAR)is an emerging biomarker that has been recently recognized to associate with adverse outcomes in a variety of cardiorespiratory disorders.However,the relationship between BAR and carotid plaque in patients with coronary heart disease(CHD)is currently unclear.Objective To investigate the correlation between BAR and carotid plaque in CHD patients.Methods Admission medical data of CHD patients hospitalized in six hospitals in Tianjin from January 2014 to September 2019 were retrospectively analyzed.BAR was calculated by dividing BUN by ALB.Logistic regression analysis was used to evaluate the correlation of BAR with the occurrence,number and characteristics of carotid plaque in CHD patients before and after adjusting for confounding factors.Drew a receiver operating characteristic(ROC)curve for diagnosing the risk of carotid plaque occurrence using BAR,and calculate the area under the ROC curve(AUC).Results A total of 10808 cases of CHD were included.Among them,8158 cases suffered from carotid plaque with a prevalence of 75.5%.The data of 10808 CHD cases were divided into four groups by quartiles of BAR(Q1,Q2,Q3,Q4)for baseline analysis:Q1≤-0.3954,-0.3954<Q2≤-0.1587,-0.1587<Q3≤0.1324,and Q4>0.1324.Compared with Q1,the correlation between BAR and carotid plaque formation was more significant in Q4 after multivariate adjustment(OR=1.512,95%CI=1.273-1.795,P<0.001).The AUC for diagnosing the risk of carotid plaque in CHD patients with BAR is 0.612(95%CI=0.600-0.624).The correlation between BAR and plaque was more significant in the female population.(OR=1.583,95%CI=1.260-1.989,P<0.001),the correlation between BAR and plaque was more significant in the older age group(OR=1.810,95%CI=1.459-2.246,P<0.001).The significant correlation between BAR and carotid plaque was not affected by diseases such as hypertension,hyperlipidemia and diabetes.Conclusion High-level BAR is associated with carotid plaque formation,and which is more significant in wom

关 键 词：冠心病 血尿素氮 血清白蛋白 颈动脉斑块 影响因素分析 天津市 

分 类 号：R541.4[医药卫生—心血管疾病]