同型半胱氨酸和低密度脂蛋白胆固醇与颈动脉内膜中层厚度对女性冠心病患者的预测价值

Predicting value of HCY, LDL-C and carotid IMT for women with CAD

目的探讨同型半胱氨酸（Hey）、低密度脂蛋白胆固醇（LDL—C）与颈动脉内膜中层厚度（IMT）对女性冠心病患者的预测价值。方法选取冠心病患者155例，非冠心病患者102例，分别测定其Hey、LDL-C及IMT，并根据不同性别进行对比研究及相关分析。结果冠心病患者中女性高Hey检出率为59．6％（31／52），高LDL-C检出率为75．0％（39／52），男性患者中分别为69．9％（72／103）和78．6％（81／103），均明显高于非冠心病患者[23．0％（7／30）、26．7％（8／30）、22．2％（16／72）、23．6％（17／72），X^2值分别为6．63、5．03、5．87、7．53，P均〈0．05]；ROC曲线分析显示女性IMT的最佳诊断界点是0．953mm，男性为1．021mm。而在这个最佳诊断界点时的灵敏度、特异度、阳性预测值、阴性预测值女性分别为83．7％、91．4％、95．7％、63．8％，均高于男性（62．9％、65．3％、76．2％、53．3％）。结论高Hey、高LDL-C血症是女性冠心病患者的重要危险因素，IMT作为冠心病的预测因子对女性患者更有优势。

Objective To assess the predicting value of homocysteine （HCY） ,low density lipoprotein cholesterin （LDL-C） and carotid intima-media thickness （IMT） for women with coronary artery disease （CAD）. Methods To choose 115 patients with CAD and 102 patients of non-CAD;Homocysteine,LDL-C and IMT were assayed respectively;comparison and correlation analysis were performed based on genders. Results The rates for hyperhomocysteinemia and High Lipoproteinaemia in female CAD patients are 59. 6% and 75.0%, respectively, while they are 69. 9% and 78.6% for male CAD patients, which are both remarkably higher than 23.0% ,26. 7%, 22. 2% and 23.6% in non-CAD patients （ Ps 〈 0. 05 ） . ROC curve shows that the best diagnostic boundary point is 0. 953 mm for female IMT and 1. 021 mm for male IMT. At the boundary point,the sensitivity,specificity,positive predictive value and negative predictive value are 83.7%, 91.4% , 95.7% and 63. 8% in female, much higher than 62. 9%, 65. 3%, 76. 2% and 53.3% in male. Conclusion hyperhomocysteinemia, high lipoproteinaemia are the important risk factors for women with coronary artery disease;IMT might be used as the predictor of CAD, which have more advantages for female than for male patients.