骨密度低下与多支病变冠心病之间的关系探讨

Study on relationship between low bone mineral density and multivessel coronary artery disease

目的探讨骨密度检测用于预测和识别多支病变冠心病的可能性。方法272例行诊断性冠状动脉造影的心绞痛患者，采用双能X线测量骨密度和冠状动脉造影术明确冠状动脉病变支数，采用多元回归分析和受试者曲线下面积进一步分析。结果骨密度低下可独立预测并识别出冠心病，采用多元回归分析发现，骨密度低下可以独立预测多支病变冠心病的存在[OR（797）；95％CI（3．32～19．16）；P〈0．001]。采用受试者曲线下面积分析发现，骨密度低下可以识别出多支病变冠心病[AUC（0．655±0．036）；95％CI（0．59～073）；P〈0．001]。结论骨密度低下可独立预测并识别出冠心病以及多支病变的冠心病患者。

Objective tifying angiographic multivesse To evaluate the possibility and ability of low bone mineral density （LBMD） predicting and iden- coronary artery disease（CAD）. Methods A total of 272 patients with chest pain, but not pre- viously diagnosed CAD who underwent index coronary angiography were examined for clinical symptoms. The association of the dual-energy X-ray absorptiometry derived LBMD with the angiographic documented multivessel coronary artery disease was analyzed by multiple logistic regression and receiver operator characteristic analysis. Results Firstly, we found that LB- MD was of independent and relative high predictive discrimination of CAD. Moreover, the prevalence of multivessel CAD was significant higher in the LBMD group than in the normal BMD group （P〈0.001）. Multivariate regression analysis revealed that LBMD was independently associated with the presence of angiographic multivessel CAD （OR = 7.97; 95% CI = 3.32- 19.16; P〈0.001）. The area of Receiver operating characteristic curve was 0.655 ＋ 0.036 （95% CI = 0.59- 0.73; P〈0.001）, indicat- ing that LBMD was of moderate predictive discrimination of multivessel CAD. Conclusion Among patients with suspected without previous diagnosed coronary artery disease, LBMD provided independent and moderate predictive discrimination of multivessel CAD.