摘要
目的 评估H型高血压合并冠心病(CHD)的危险因素及其与胆红素血脂综合指数的相关性,探讨该指数在这些患者中的预测价值。方法 选择2018年1月—2023年12月本院收治的H型高血压患者375例作为研究对象,根据冠状动脉造影结果,将患者分为对照组(H型高血压未合并冠心病,236例)和实验组(H型高血压合并冠心病,139例)两组。比较两组患者的临床资料、生化指标、胆红素血脂综合指数的差异。运用Spearman相关分析探讨胆红素血脂综合指数与Gensini评分等相关性,使用logistic回归分析及ROC曲线研究H型高血压合并CHD的相关危险因素及胆红素血脂综合指数的预测价值。结果 两组在AST、TBIL、TC、LDL-C、HDL-C、LDL-C/(HDL-C+TBIL)和TC/(HDL-C+TBIL)的差异均有统计学意义(均P<0.05)。多因素回归分析校正后,LDL-C/(HDL-C+TBIL)(OR=8.32,95%CI3.92~17.68,P<0.001)及TC/(HDL-C+TBIL)(OR=2.03,95%CI1.23~17.68,P=0.006)的升高是H型高血压合并CHD的危险因素(P<0.05)。ROC曲线分析显示,LDL-C/(HDL-C+TBIL)的AUC为0.703,敏感度为70.8%,特异度为59%;TC/(HDL-C+TBIL)的AUC为0.667,敏感度为70.3%,特异度为54.7%。结论 AST和LDL-C升高是H型高血压合并CHD的独立危险因素,而TBIL和HDL-C是保护因素。LDL-C/(HDL-C+TBIL)、TC/(HDL-C+TBIL)在H型高血压患者预测CHD中具有较好的预测价值。
Objective To evaluate the risk factors of H-type hypertension complicated with coronary heart disease(CHD) and its correlation with the bilirubin-lipid composite index,and to explore the predictive value of the index in these patients.Methods This study included patients with H-type hypertension who were admitted to Wuhan third hospital from January 2018 to December 2023.According to the results of coronary angiography,the patients were divided into the control group(H-type hypertension without CHD) and the experimental group(H-type hypertension with CHD).The differences in clinical data,biochemical indicators,and the bilirubin-lipid composite index between the two groups were compared.Spearman correlation analysis was used to explore the correlation between the bilirubin-lipid composite index and Gensini score.Logistic regression analysis and ROC curve were used to study the related risk factors of H-type hypertension with CHD and the predictive value of the bilirubin-lipid composite index.Results A total of 375 patients were included in this study.Significant differences were observed between the two groups in AST,TBIL,TC,LDL-C,HDL-C,LDL-C/(HDL-C+TBIL),and TC/(HDL-C+TBIL)(all P<0.05).After adjustment in multivariate regression analysis,elevated levels of LDL-C/(HDL-C+TBIL)(OR=8.32,95% CI:3.92~17.68,P<0.001) and TC/(HDL-C+TBIL)(OR=2.03,95% CI:1.23~17.68,P=0.006) were found to be risk factors for H-type hypertension with CHD(P<0.05).ROC curve analysis showed that the AUC of LDL-C/(HDL-C+TBIL) was 0.703,with a sensitivity of 70.8% and a specificity of 59%.The AUC of TC/(HDL-C+TBIL) was 0.667,with a sensitivity of 70.3% and a specificity of 54.7%.Conclusions Elevated levels of AST and LDL-C are independent risk factors for H-type hypertension with CHD,while TBIL and HDL-C are protective factors.LDL-C/(HDL-C+TBIL) and TC/(HDL-C+TBIL) have good predictive value in predicting H-type hypertension with CHD.
作者
陈佩娴
邱睿
朱书秀
李东升
Chen Peixian;Qiu Rui;Zhu Shuxiu;Li Dongsheng(School of Medicine,Jianghan University,Wuhan,Hubei 430056,China;Department of Cardiovascular Medicine,the Third Hospital of Wuhan(Wuhan University Tongren Hospital),Wuhan,Hubei 430056,China)
出处
《齐齐哈尔医学院学报》
2025年第10期928-933,共6页
Journal of Qiqihar Medical University
基金
医防融合型的区域化健康管理联合体的构建与实践(WY22A08)。
关键词
冠心病
H型高血压
胆红素血脂综合指数
冠心病
总胆红素
Coronary heart disease
H-type hypertension
Bilirubin blood lipid Comprehensive index
Total bilirubin
作者简介
通信作者:李东升,Email:dongshengli196809@163.com。
