红细胞分布宽度和纤维蛋白原与白蛋白比值对冠状动脉疾病严重程度的预测价值分析

Predictive values of red blood cell distribution width and fibrinogen to albumin ratio for severity of coronary artery disease

目的 评估冠心病(CHD)患者红细胞分布宽度/白蛋白比值(RAR)和纤维蛋白原/白蛋白比值(FAR)与冠状动脉疾病(CAD)严重程度的关系,并进一步探讨不同糖代谢状态下RAR和FAR与CAD严重程度的关系。方法选取2021年1月至2022年12月于天津市人民医院心脏内科行冠状动脉造影术的CHD患者577例,其中CAD多支病变组412例,CAD单支病变组165例。收集患者基线资料和实验室相关检查并计算RAR和FAR;分别以RAR和FAR为自变量进行单因素和多因素logistic回归分析;采用受试者工作曲线(ROC)分析RAR和FAR对CHD患者CAD严重程度的预测价值;Spearman相关性分析患者的主要不良心血管事件(MACE)发生情况。结果Logistic回归分析显示,RAR和FAR是CAD严重程度的独立危险因素(OR=1.974,95%CI:1.348~2.593,P=0.000;OR=1.737,95%CI:1.486~2.377,P=0.000)。在不同糖代谢状态下,RAR是糖尿病患者CAD严重程度的最高危险因素(OR=2.828,95%CI:1.157~7.145),而FAR在糖尿病患者CAD发生风险预测中处于相对较低影响(OR=2.217,95%CI:1.533~5.570)。ROC曲线分析显示,RAR(AUC=0.776,95%CI:0.731~0.821,P=0.000)和FAR(AUC=0.725,95%CI:0.676~0.774,P=0.000)对CHD患者CAD严重程度具有预测价值。Spearman相关性分析显示,CHD患者血清RAR和FAR水平与MACE呈正相关(P<0.001)。结论 RAR和FAR是CHD患者CAD严重程度的独立危险因素;RAR对CHD合并糖代谢异常患者CAD严重程度更具有预测价值。

Objective To explore the correlation of red cell distribution width/albumin ratio(RAR)and fibrinogen/albumin ratio(FAR)with severity of coronary artery disease(CAD)in patients with coronary heart disease(CHD),and to further explore the relationship of RAR and FAR with CAD severity in different glucose metabolic states.Methods A total of 577 CHD patients undergoing coronary angiography(CAG)in Department of Cardiology of Tianjin People's Hospital from January 2021 to December 2022 were enrolled,and according to the results of CAG,412 patients were diagnosed with multi-vessel CAD and the other 165 patients with singlevessel CAD.Their baseline data and results of laboratory tests were collected,and RAR and FAR values were calculated.Univariate and multivariate logistic regression analyses were performed with RAR and FAR as independent variables,and ROC curve was plotted to evaluate the predictive values of the 2 indicators for the severity of CAD.Spearman correlation analysis was applied to analyze the occurrence of major adverse cardiovascular events(MACEs)in the patients.Results Logistic regression analysis showed that RAR and FAR were independent risk factors for CAD(OR=1.974,95%CI:1.348-2.593,P=0.000;OR=1.737,95%CI:1.486-2.377,P=0.000).Under different glucose metabolic states,RAR had the highest correlation with the risk of CAD in diabetic patients(OR=2.828,95%CI:1.157-7.145),while FAR was associated with a relatively low risk of CAD in diabetic patients(OR=2.217,95%CI:1.533-5.570).ROC curve analysis showed that RAR(AUC=0.776,95%CI:0.731-0.821,P=0.000)and FAR(AUC=0.725,95%CI:0.676-0.774,P=0.000)had predictive value for the severity of CAD in CHD patients.Spearman correlation analysis indicated that RAR and FAR were positively correlated with occurrence of MACEs in CHD patients(P<0.001).Conclusion RAR and FAR are independent predictors for CHD patients.RAR has a stronger predictive value for lesion severity in CHD patients with concomitant abnormal glucose metabolism.