冠心病患者的血清Hcy和颈动脉超声参数检测结果及其对冠状动脉狭窄程度的预测价值  

Value of serum homocysteine and carotid ultrasound parameters in predicting the degree of coronary artery stenosis in patients with coronary heart disease

作　　者：刘甜 黄松雄 LIU Tian;HUANG Song-xiong(Health Management Center,The Second People’sHospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350000,China)

机构地区：[1]福建省中医药大学附属第二人民医院健康管理中心,福建福州350000

出　　处：《心血管病防治知识(学术版)》2024年第21期26-30,共5页Prevention and Treatment of Cardiovascular Disease

摘　　要：目的分析同型半胱氨酸(Hcy)与颈动脉超声参数联合预测冠心病患者冠脉狭窄程度的价值。方法选取2021年2月至2023年2月本院收治的92例冠心病患者,依据Gensini评分将患者分为轻度组(n=53)与中重度组(n=39),以单因素确定一般资料、Hcy、颈动脉超声参数[颈动脉内膜中层厚度(IMT)、颈动脉斑块Crouse积分]与冠心病患者冠脉狭窄程度的关系;用多因素确定影响患者冠脉狭窄程度的危险因素;另绘制受试者工作曲线(ROC),分析Hcy、IMT、颈动脉斑块Crouse积分预测冠心病患者冠脉狭窄程度的价值。结果中重度组的Hcy为(17.89±2.46)µmol/L、IMT为(1.41±0.39)mm、颈动脉斑块Crouse积分为(3.28±0.57)分,高于轻度组的(13.41±2.15)µmol/L、(1.01±0.26)mm、(1.79±0.32)分,有统计学差异(P<0.05);多元线性回归分析显示:Hcy、IMT、颈动脉斑块Crouse积分是影响冠心病患者冠脉狭窄程度的高危因素(P<0.05);ROC结果显示:Hcy、IMT、颈动脉斑块Crouse积分联合预测冠心病患者冠脉狭窄程度的曲线下面积(AUC)为0.927(95%CI=0.869-0.985),高于三者单独预测的0.854(95%CI=0.777-0.931)、0.800(95%CI=0.701-0.899)、0.863(95%CI=0.788-0.938)。结论Hcy联合颈动脉超声参数可有效的预测出冠心病患者的冠脉狭窄程度,存在一定的应用价值,值得临床推广应用。Objective To investigate the value of homocysteine(Hcy)combined with carotid artery ultrasound pa-rameters in predicting the degree of coronary artery stenosis in patients with coronary heart disease.Methods A total of 92 patients with coronary heart disease who were admitted to our hospital from February 2021 to February 2023 were en-rolled,and according to the Gensini score,they were divided into mild group with 53 patients and moderate-to-severe group with 39 patients.A univariate analysis was used to investigate the association of general information,Hcy,and carotid artery ultrasound parameters(carotid intima-media thickness[IMT]and carotid plaque Crouse score)with the degree of coronary artery stenosis in patients with coronary heart disease,and a multivariate analysis was used to identify the risk fac-tors for the degree of coronary artery stenosis.The receiver operating characteristic(ROC)curve was plotted to investigate the value of Hcy,IMT,and carotid plaque Crouse score in predicting the degree of coronary artery stenosis in patients with coronary heart disease.Results Compared with the mild group,the moderate-to-severe group had significantly higher Hcy(17.89±2.46µmol/L vs 13.41±2.15µmol/L,P<0.05),IMT(1.41±0.39 mm vs 1.01±0.26 mm,P<0.05),and carotid plaque Crouse score(3.28±0.57 vs 1.79±0.32,P<0.05).The multiple linear regression analysis showed that Hcy,IMT,and carotid plaque Crouse score were high-risk factors for the degree of coronary artery stenosis in patients with coronary heart disease(P<0.05).The ROC curve analysis showed that the combination of Hcy,IMT,and carotid plaque Crouse score had an area under the ROC curve(AUC)of 0.927(95%confidence interval[CI]:0.869-0.985)in predicting the degree of coro-nary artery stenosis in patients with coronary heart disease,while the three indicators alone had an AUC of 0.854(95%CI:0.777-0.931),0.800(95%CI:0.701-0.899),and 0.863(95%CI:0.788-0.938),respectively.Conclusion Hcy combined with carotid ultrasound parameters can effectively predict the degr

关 键 词：冠心病 冠状动脉狭窄 同型半胱氨酸 颈动脉超声 

分 类 号：R541.4[医药卫生—心血管疾病]