摘要
目的探讨甘油三酯葡萄糖(triglyceride-glucose index,TyG)指数、脂蛋白a[Lp(a)]对急性冠状动脉综合征(acute coronary syndrome,ACS)患者冠状动脉病变严重程度的评价及预测价值。方法纳入2022年1月至2022年12月就诊于西安交通大学第二附属医院的ACS患者241例,根据冠状动脉造影Gensini评分分为冠状动脉轻度病变组(Gensini评分≤20分,98例)、中度病变组(20分<Gensini评分≤40分,60例)和重度病变组(Gensini评分>40分,83例)。收集所有入选患者基线资料,采集血样并进行Lp(a)、血清甘油三酯、空腹葡萄糖等指标检测。采用SPSS 27.0软件统计并进行数据分析,对符合正态分布的数据组间比较采用单因素方差分析,不符合正态分布的数据组间比较采用非参数秩和检验(Kruskal-Wallis检验),计数资料组间比较采用χ^(2)检验;采用有序多元Logistic回归分析探究ACS患者冠状动脉病变严重程度的影响因素;采用Spearman相关性分析TyG指数、Lp(a)与冠状动病变严重程度的相关性;绘制受试者工作特征(ROC)曲线评估TyG指数、Lp(a)及其联合指标对重度冠状动脉病变的预测价值。结果三组患者TyG指数、Lp(a)组间比较具有两两差异(P<0.001),有序多元Logistic回归分析显示TyG指数和Lp(a)升高是影响ACS患者冠状动脉病变严重程度增加的独立危险因素。Spearman分析显示,TyG指数(r=0.384,P<0.001)、Lp(a)(r=0.523,P<0.001)与冠状动脉病变Gensini评分呈正相关。TyG指数联合Lp(a)评估重度冠状动脉病变的ROC曲线下面积为0.854(95%CI:0.804~0.905),(P<0.001)。结论TyG指数、Lp(a)与ACS患者冠状动脉病变严重程度呈正相关,应用TyG指数联合Lp(a)具有评价冠状动脉病变严重程度的意义。
Objective To investigate the value of the triglyceride-glucose(TyG)index and the lipoprotein a[Lp(a)]in predicting the severity of coronary artery stenosis in patients with acute coronary syndrome(ACS).Methods A total of 241 ACS patients who underwent coronary angiography at the Second Affiliated Hospital of Xi'an Jiaotong University from January 2022 to December 2022 were retrospectively included.All patients were divided into three groups according to the Gensini score:mild stenosis group(98cases,Gensini score≤20),moderate stenosis group(60cases,20<Gensini score≤40),and severe stenosis group(83cases,Gensini score>40).Collect baseline data for all eligible patients,take blood samples,and measure indicators such as Lp(a),serum triglycerides,and fasting glucose.Data will be statistically analyzed using SPSS software version 27.For data following a normal distribution,one-way ANOVA will be used for group comparisons,while for non-normally distributed data,the Kruskal-Wallis test will be applied.Categorical data will be compared using theχ^(2) test.Ordinal logistic regression will be employed to explore the factors influencing the severity of coronary artery lesions in ACS patients.Spearman correlation analysis will be used to assess the relationship between the TyG index,Lp(a),and the severity of coronary artery lesions.Receiver operating characteristic(ROC)curves will be plotted to evaluate the predictive value of the TyG index,Lp(a),and their combined metrics for severe coronary artery lesions.Results At baseline,the TyG index and the Lp(a)showed statistically significant differences among the three groups(P<0.001).Ordinal logistic regression analysis confirmed that TyG index and Lp(a)were independent risk factors causing coronary artery stenosis.In addition,Spearman correlation analysis showed a positive correlation between TyG index(r=0.384,P<0.001)or Lp(a)(r=0.523,P<0.001)and the degree of coronary artery stenosis.The diagnostic value of TyG index combined with Lp(a)for coronary severe stenosis showed that the area under the curve was 0.854(95%CI:0.804~0.905,P<0.001).Conclusion TyG index and Lp(a)are closely related to the severity of coronary artery stenosis,and the combination of TyG index and Lp(a)has a good value in reflecting coronary artery stenosis.
作者
孙玉宇
金萍
李青
李丹妮
夏林莺
高登峰
Sun Yuyu;Jin Ping;Li Qing;Li Danni;Xia Linying;Gao Dengfeng(Department of Cardiovascular Medicine,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China;不详)
出处
《中国循证心血管医学杂志》
2024年第12期1452-1456,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
陕西省自然科学基础研究计划青年项目(2022JQ-787)。
作者简介
通讯作者:高登峰,E-mail:gaomedic@163.com。
