甘油三酯和葡萄糖指数、胰岛素抵抗代谢积分、甘油三酯与高密度脂蛋白胆固醇比值在急性冠状动脉综合征合并多支冠状动脉病变患者中的应用价值  

Application values of triglyceride and glucose index,metabolic insulin resistance score and triglyceride to high-density lipoprotein cholesterol ratio in patients with acute coronary syndrome complicated with multivessel coronary artery disease

作　　者：卯骏聪 洪云飞 魏引 蔡叶锐 尹劲松 MAO Juncong;HONG Yunfei;WEI Yin;CAI Yerui;YIN Jinsong(Department of Cardiology,Yunnan Provincial Third People's Hospital,the Second Affiliated Hospital of Dali University,Kunming,Yunnan,650000)

机构地区：[1]云南省第三人民医院/大理大学第二附属医院心内科,云南昆明650000

出　　处：《实用临床医药杂志》2025年第5期56-63,共8页Journal of Clinical Medicine in Practice

基　　金：云南省教育厅科学研究基金项目(2025J0783)。

摘　　要：目的评估甘油三酯和葡萄糖(TyG)指数、胰岛素抵抗代谢积分(METSIR)以及甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)对急性冠状动脉综合征(ACS)合并多支冠状动脉病变患者发病风险及病变程度的预测能力。方法回顾性分析云南省第三人民医院收治的260例ACS患者的临床资料,将其分为多支病变组(n=160)和非多支病变组(n=100);根据SYNTAX评分将多支病变组分为高危组71例(评分>22.5分)和低危组89例(评分≤22.5分)。结果多支病变组男性比率、糖尿病史、吸烟史、TyG指数、METSIR及TG/HDL-C均高于非多支病变组,差异有统计学意义(P<0.05)。相关性分析显示,TyG指数、TG/HDL-C与SYNTAX评分呈显著正相关(P<0.05),而METSIR与SYNTAX评分无相关性(P>0.05)。Logistic回归分析表明,METSIR是ACS合并多支冠状动脉病变的独立危险因素(P<0.05),TyG、METSIR和TG/HDL-C均为预测病变严重程度的独立因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,TyG指数对ACS合并多支冠状动脉病变及其严重程度方面具有最高的预测价值(曲线下面积为0.804)。结论TyG指数、METSIR及TG/HDL-C在ACS合并多支冠状动脉病变的早期识别和评估中具有重要意义,其中TyG指数的预测价值最高。Objective To evaluate the predictive abilities of the triglyceride and glucose(TyG)index,metabolic insulin resistance score(METSIR),and ratio of triglyceride to high-density lipoprotein cholesterol(TG/HDL-C)for the risk of onset and severity of lesions in patients with acute coronary syndrome(ACS)complicated with multivessel coronary artery disease.Methods A retrospective analysis was conducted on the clinical data of 260 ACS patients admitted to Yunnan Provincial Third People's Hospital,and the patients were divided into multivessel disease group(n=160)and non-multivessel disease group(n=100);based on the SYNTAX score,the multivessel disease group was further divided into high-risk group with 71 cases(score>22.5)and low-risk group with 89 cases(score≤22.5).Results The multivessel disease group had significantly higher proportions of males,history of diabetes,history of smoking,TyG index,METSIR,and TG/HDL-C compared to the non-multivessel disease group(P<0.05).Correlation analysis showed that the TyG index and TG/HDL-C were significantly positively correlated with the SYNTAX score(P<0.05),while METSIR had no correlation with the SYNTAX score(P>0.05).Logistic regression analysis indicated that METSIR was an independent risk factor for ACS complicated with multivessel coronary artery disease(P<0.05),and TyG,METSIR and TG/HDL-C were all independent factors for predicting the severity of lesions(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that TyG had the highest predictive value for ACS complicated with multivessel coronary artery disease and its severity(area under the curve was 0.804).Conclusion The TyG index,METSIR,and TG/HDL-C are of great significance in the early identification and assessment of ACS complicated with multivessel coronary artery disease,with TyG having the highest predictive value.

关 键 词：急性冠状动脉综合征 多支冠状动脉病变 甘油三酯和葡萄糖指数 胰岛素抵抗代谢积分 甘油三酯与高密度脂蛋白胆固醇比值 SYNTAX积分 

分 类 号：R589[医药卫生—内分泌] R541.4[医药卫生—内科学] R442.8[医药卫生—临床医学]