冠心病患者多支病变的预测因素分析  

Analysis of predictive factors for multi-vessel disease in patients with coronary heart disease

作　　者：韩睿 潘婉倩 张宇祯[1] 陈伟翔 蒋廷波[1] HAN Rui;PAN Wanqian;ZHANG Yuzhen;CHEN Weixiang;JIANG Tingbo(Department of Cardiology,the First Affiliated Hospital of Soochow University,Jiangsu Province,Suzhou215031,China)

机构地区：[1]苏州大学附属第一医院心内科,江苏苏州215031

出　　处：《中国当代医药》2025年第6期27-30,共4页China Modern Medicine

基　　金：国家自然科学基金(82370512);江苏省高等学校基础科学(自然科学)研究项目(23KJB320019)。

摘　　要：目的探索冠心病多支病变的预测因素。方法选取2023年1月至3月苏州大学附属第一医院收治的143例冠心病患者为研究对象,根据冠脉狭窄程度分为单支病变组(62例)和多支病变组(81例)。收集两组患者的临床资料,采用多因素logistic回归分析评估多支病变的影响因素,绘制ROC曲线分析多支病变的预测因素。结果两组患者的收缩压(SBP)、舒张压(DBP)、饮酒史、吸烟史、既往经皮冠状动脉介入术(PCI)史、血尿酸、高密度脂蛋白胆固醇(HDL-C)及载脂蛋白A1(ApoA1)比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,吸烟史(β=0.946,OR=2.575,95%CI:1.209~5.485)、SBP(β=0.022,OR=1.023,95%CI:1.002~1.044)为多支病变的独立危险因素,HDL-C(β=-1.450,OR=0.235,95%CI:0.060~0.921)为独立保护因素。ROC分析显示,HDL-C和SBP对多支病变均有一定预测价值(AUC=0.610和0.633),吸烟和HDL-C及SBP的三者联合预测多支病变的效能优于单一指标(AUC=0.688)。结论吸烟和SBP是冠心病多支病变发生的危险因素,临床需注意观察,且HDL-C和SBP对冠心病多支病变的发生有一定的预测价值。Objective To explore the predictive factors of multi-vessel disease in coronary heart disease.Methods A total of 143 patients with coronary artery disease admitted to the First Affiliated Hospital of Soochow University from January to March 2023 were selected as the study objects.According to the degree of coronary artery stenosis,they were divided into single-vessel disease group(62 cases)and multi-vessel disease group(81 cases).The clinical data of the two groups of patients were collected,the influencing factors of multi-vessel lesions were evaluated by multivariate logistic regression analysis,and the predictive factors of multi-vessel lesions were analyzed by ROC curve.Results There were significant differences in systolic blood pressure(SBP),diastolic blood pressure(DBP),drinking history,smoking history,history of percutaneous coronary intervention(PCI),blood uric acid,high density lipoprotein cholesterol(HDL-C)and apolipoprotein A1(ApoA1)between two groups(P<0.05).Multivariate logistic regression analysis showed that smoking history(β=0.946,OR=2.575,95%CI:1.209-5.485),SBP(β=0.022,OR=1.023,95%CI:1.002-1.044)were independent risk factors for multi-vessel lesions,and HDL-C(β=-1.450,OR=0.235,95%CI:0.060-0.921)was independent protective factor.ROC analysis showed that both HDL-C and SBP had certain predictive value for multi-vessel lesions(AUC=0.610 and 0.633),and the combined effect of smoking,HDL-C and SBP on the prediction of multi-vessel disease was better than that of single index(AUC=0.688).Conclusion Smoking and SBP are risk factors for coronary heart disease,which should be observed in clinic.In addition,HDL-C and SBP have certain predictive value for the occurrence of multi-vessel disease in coronary heart disease.

关 键 词：冠心病 多支病变 高密度脂蛋白胆固醇 收缩压 预测 

分 类 号：R50[医药卫生—内科学]