残余胆固醇和TG/HDL-C与慢性冠脉综合征患者冠状动脉病变程度及短期预后的相关性  

Association of residul cholesterol and TG/HDL-C with coronary disease severity and short-term prognosis in patients with chronic coronary syndrome

作　　者：于猛 孙维 刘明新 董智雯 李文锋 YU Meng;SUN Wei;LIU Mingxin;DONG Zhiwen;LI Wenfeng(Department of Cardiology,The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001;Department of Cardiology,The First People's Hospital Jinzhou Dalian,Dalian 116100,China)

机构地区：[1]锦州医科大学附属第一医院心内科,121000 [2]大连市金州区第一人民医院心内科,116100

出　　处：《国际心血管病杂志》2025年第2期123-128,共6页International Journal of Cardiovascular Disease

摘　　要：目的:探讨残余胆固醇(RC)和甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)与慢性冠脉综合征(CCS)患者冠状动脉病变程度的相关性及短期预后分析。方法:选取2022年1月至2023年6月CCS患者964例,收集患者临床资料及随访1年内发生主要不良心血管事件(MACE)情况,依据Gensini评分中位数(24分)分为低分组及高分组,进行二元logistic回归分析并绘制受试者工作特征(ROC)曲线,同时按照发生MACE事件情况进行Cox回归分析,并计算RC和TG/HDL-C的最佳截断值。结果:多因素二元logistic分析表明RC(OR=1.588,95%CI:1.365~1.846,P<0.001)及TG/HDL-C(OR=1.811,95%CI:1.551~2.114,P<0.001)是CCS患者冠状动脉病变严重程度的独立危险因素。RC[ROC曲线下面积(AUC)=0.651,95%CI:0.616~0.685,P<0.001]及TG/HDL-C(AUC=0.685,95%CI:0.651~0.719,P<0.001)对CCS患者冠状动脉病变严重程度有一定的预测能力,最佳截断值分别为0.632和3.755。多因素Cox回归分析发现,RC(HR=1.570,95%CI:1.280~1.902,P<0.001)、TG/HDL-C(HR=1.593,95%CI:1.294~1.692,P<0.001)是CCS患者1年内发生MACE的独立危险因素,最佳截断值分别为0.700和3.900。结论:RC和TG/HDL-C是CCS患者冠状动脉病变严重程度和1年内发生不良预后的独立危险因素,并对冠状动脉病变程度有一定预测价值。Objective:This study investigated the relationship of residual cholesterol and triglycerides-to-high-density lipoprotein cholesterol(TG/HDL-C)ratio to the severity of coronary artery disease and short-term outcome in patients with chronic coronary syndrome(CCS).Methods:A total of 964 CCS patients who met the inclusion and exclusion criteria from January 2022 to June 2023 were recruited.Clinical data and occurrence of major adverse cardiac events(MACE)within one year of follow-up were recorded.Gensini score>24 was considered as severe coronary artery disease.Binary logistic regression analysis was performed,and ROC curves were generated.COX regression analysis was made to determine the factors for the occurrence of MACE.Results:Multivariate binary logistic analysis revealed that residual cholesterol(OR=1.588,95%CI:1.365-1.846,P<0.001)and TG/HDL-C ratio(OR=1.811,95%CI:1.551-2.114,P<0.001)were independent factors for the severity of coronary artery disease in patients with CCS.The predictive ability of residual cholesterol(AUC=0.651,95%CI:0.616-0.685,P<0.001)and TG/HDL-C ratio(AUC=0.685,95%CI:0.651-0.719,P<0.001)for the severity of coronary artery disease was notable,with optimal cutoff values of 0.632 and 3.755,respectively.In addition,residual cholesterol(HR=1.570,95%CI:1.280-1.902,P<0.001)and TG/HDL-C ratio(HR=1.593,95%CI:1.294-1.692,P<0.001)were identified as independent predictors for MACE within one year,with optimal cutoff values of 0.700 and 3.900,respectively.Conclusion:Both residual cholesterol and TG/HDL-C ratio are independent risk factors associated with the severity of coronary artery disease and short-term prognosis in patients with CCS.

关 键 词：慢性冠脉综合征 甘油三酯与高密度脂蛋白胆固醇比值 残余胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]