冠心病心血管病危险因素诊断试验分析

Value of risk factors in diagnosis of coronary heart disease in patients underwent coronary angiography

目的对心血管病危险因素进行诊断试验,探讨其对冠心病的诊断价值。方法于2008年10月-2009年12月对山东大学齐鲁医院行冠状动脉造影术的812例患者,进行心血管病危险因素及冠脉造影结果进行分析。结果根据冠脉造影结果确诊冠心病662例,将患者分为冠心病组与非冠心病组,应用Logistics回归分析结果表明,男性、年龄、高血压(HT)、糖尿病(DM)、高密度脂蛋白胆固醇(HDL-C)是冠心病的主要危险因素;冠脉造影结果表明,这5个危险因素对冠心病诊断的敏感性为95.47%(632/662),特异性为64.00%(96/150),阳性预测值为92.13%(632/686),阴性预测值为76.19%(96/126)。结论男性、年龄、高血压、糖尿病、低HDL-C是冠心病的主要危险因素,其联合应用对冠心病有较高的诊断价值。

Objective To evaluate the significance of risk factors in the diagnosis of coronary heart disease（CHD） in patients underwent coronary angiography.Methods A total of 812 patients underwent coronary angiography were selected according to the inclusion criteria in Qilu Hospital from October 2008 to December 2009.Cardiovascular risk factors included age,gender,hypertension,smoking status,type 2 diabetes mellitus,dyslipidemia,high uric acid level,and low total bilirubin level.The sensitivity and specificity of the cardiovascular risk factors for diagnosis of CHD were analyzed.Analyses were aconducted with multiple logistic regression analysis.Results Gender,age,low high-density lipoprotein cholesterol（HDL-C） level,hypertension,and type 2 diabetes mellitus were significant predictors of CHD by logistic regression analyses,with a sensitivity of 95.47% and a specificity of 64.00%.The positive predictive value and negative predictive value were 92.13% and 76.19%.The area under curve（AUC） of receiver operating characteristic curve（ROC） was 0.75.Conclusion Age,gender,hypertension,type 2 diabetes mellitus,and low HDL-C correlate with CHD and have a high sensitivity and specificity for the diagnosis of CHD.