摘要
目的探讨脂质蓄积指数(LAP)与血浆致动脉硬化指数(AIP)联合检测对冠状动脉粥样硬化性心脏病(CHD)稳定期再发心血管事件的预测价值。方法选取2019年2月至2021年2月延安大学咸阳医院收治的204例稳定期CHD患者作为观察组,以同期在我院体检的100例健康人为对照组,检测两组受检者的腰围(WC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)水平,并计算LAP和AIP。追踪随访观察组患者1年,失访6例,根据是否出现心血管事件将其分为发生组(31例)和未发生组(167例)。收集发生组和未发生组患者的临床资料,采用单因素和多因素Logistic回归分析筛选稳定期CHD患者再发心血管事件的影响因素,并绘制受试者工作特征曲线(ROC)分析LAP和AIP联合检测对稳定期CHD患者再发心血管事件的预测价值。结果观察组患者的WC、TG、TC、LDL-C水平明显高于对照组,而HDL-C明显低于对照组,差异均有统计学意义(P<0.05);观察组患者的LAP、AIP分别为54.95±5.58、0.28±0.03,明显大于对照组的39.03±4.12、0.09±0.01,差异均有统计学意义(P<0.05);心血管事件发生组患者的糖尿病比例、TG、TC、LDL-C水平、冠脉Gensini积分、左室舒张末内径(LVEDd)、LAP、AIP明显高于未发生组,而HDL-C明显低于未发生组,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,糖尿病、TG、HDL-C、冠脉Gensini积分、LAP、AIP均是影响稳定期CHD患者再发心血管事件的影响因素(P<0.05);经ROC分析结果显示,LAP、AIP对稳定期CHD患者再发心血管事件预测能力的的AUC分别为0.747(95%CI:0.643~0.852)、0.755(95%CI:0.652~0.858),均小于两项联合的0.853(95%CI:0.749~0.957)。结论稳定期CHD患者LAP、AIP较高,两者均是影响稳定期CHD患者再发心血管事件的影响因素,可在一定程度上作为该类患者再发心血管事件的预测指标,且联合检测预测价值更高。
Objective To investigate the predictive value of lipid accumulation index(LAP)combined with atherogenic index of plasma(AIP)for recurrent cardiovascular events in the stable phase of coronary atherosclerotic heart disease(CHD).Methods A total of 204 patients with stable CHD admitted to Xianyang Hospital of Yan'an Uni-versity from February 2019 to February 2021 were selected as the observation group,and 100 healthy individuals who were examined in the hospital during the same period were selected as the control group.The waist circumference(WC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)levels of the subjects in both groups were measured,and LAP and AIP were calculated.Patients in the observation group were followed up for 1 year,and 6 patients were lost to follow-up.The remaining 198 patients were divided into the occur-rence group(31 cases)and the non-occurrence group(167 cases)according to whether they had cardiovascular events.The clinical data of patients in the occurrence and non-occurrence groups were collected,and the influencing factors of recurrent cardiovascular events in patients with stable CHD were screened by univariate and multifactorial logistic re-gression analysis.The predictive value of combined detection of LAP and AIP on recurrent cardiovascular events in pa-tients with stable CHD was analyzed by receiver operating characteristic curve(ROC).Results The levels of WC,TG,TC,and LDL-C in the observation group were significantly higher than those in the control group,while HDL-C was sig-nificantly lower than that in the control group,with statistically significant differences(P<0.05).The LAP and AIP of pa-tients in the observation group were 54.95±5.58 and 0.28±0.03,respectively,which were significantly greater than 39.03±4.12 and 0.09±0.01 of the control group(P<0.05).The proportion of diabetes mellitus,TG,TC,LDL-C levels,coronary Gensini score,left ventricular end-diastolic internal diameter(LVEDd),LAP,and AIP were significantly higher in the patients in occurrence group than non-occurrence group,while HDL-C was significantly lower,with statistically sig-nificant differences(P<0.05).The results of logistic regression analysis showed that diabetes mellitus,TG,HDL-C,coro-nary Gensini score,LAP,and AIP were all influential factors affecting recurrent cardiovascular events in patients with sta-ble CHD(P<0.05).The results of ROC analysis showed that the AUCs of the predictive ability of LAP and AIP for recur-rent cardiovascular events in patients with stable CHD were 0.747(95%CI:0.643-0.852)and 0.755(95%CI:0.652-0.858),respectively,which were smaller than 0.853(95%CI:0.749-0.957)of combined detection.Conclusion LAP and AIP in patients with stable CHD are higher.Both of them are factors that affect the recurrence of cardiovascular events in pa-tients with stable CHD.They both can be used as predictive indicators for recurrence of cardiovascular events in these patients to a certain extent,and the combined detection of the two indexes may have higher predictive value.
作者
张树远
王端乐
ZHANG Shu-yuan;WANG Duan-le(Third Department of Cardiology,Xianyang Hospital of Yan'an University,Xiangyang 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2023年第3期330-334,共5页
Hainan Medical Journal
作者简介
第一作者:张树远(1987-),男,主治医师,主要研究方向为心血管系统疾病;通讯作者:王端乐(1989-),男,主治医师,主要研究方向为心血管系统疾病,E-mail:ruiruidoc@163.com。
