血浆致动脉硬化指数对冠心病的预测价值

The value of atherogenic index of plasma in predicting coronary heart disease

目的比较血浆致动脉硬化指数(AIP)与脉搏波传导速度(PWV)对冠心病预测的准确性,探讨AIP检测用于预测冠心病的可行性。方法收集在我院住院且疑诊为冠心病并行冠状动脉造影(CAG)检查的患者316例,其中男196例,女120例,年龄为60.60±9.83岁,根据CAG结果分为冠心病组(n=218)和非冠心病组(n=98),采用Logistic回归方法筛选冠心病的独立危险因素,并分析AIP与PWV对冠心病诊断的预测价值。结果冠心病组患者AIP和PWV均明显高于无冠心病组(P<0.01);Logistic多因素回归分析显示,AIP和PWV是冠心病的独立危险因素(P<0.01),且二者呈正相关(r=0.830,P<0.01);在AIP和PWV预测冠心病能力的受试者工作特征曲线(ROC)中,其曲线下面积分别为0.764(95%CI为0.683~0.802,P<0.01)及0.721(95%CI为0.642~0.784,P<0.01);当AIP取0.161及PWV取1362 cm/s最佳临界值时,二者对冠心病诊断的敏感性、特异性、准确性均无差别(P>0.05)。结论 AIP可用于冠心病的预测,尤其是当AIP水平超过0.161时诊断冠心病的可能性大。

Aim To explore the feasibility of atherogenic index of plasma （AIP） in predicting coronary heart disease （CHD） by comparing the predictive value of AIP and pulse wave velocity （PWV） on coronary heart disease. Methods A total of 316 patients （ 196 males and 120 females） with chest pain suspected coronary heart disease were taken the coronary angiography （CAG） in our hospital. Study subjects were divided into coronary heart disease group and non-coronary heart disease group according to the results of CAG. The independent risk factors of coronary heart disease were analyzed by multivariate Logistic regression analysis and predictive value on coronary heart disease were compared be- tween the two groups. Results The levels of AIP and PWV were significantly higher in coronary heart disease group than those in non-coronary heart disease group （P〈0.01）. Multivariate Logistic regression analysis revealed that high AIP and PWV were independent risk factors of coronary heart disease （P〈0.01）. AIP was positively correlated with PWV in coronary heart disease patients （r=0.830, P〈0.01）. Area under the curve for AIP and PWV in evaluating prognosis of coronary heart disease were 0.764 （95%CI was 0.683-0.802, P〈0.01） and 0.721 （95%CI was 0.642-0.784, P〈0.01）. At the optimal point, there was no significant difference between the two groups in sensitivity, specificity and accuracy for coronary heart disease in statistics （P〉0.05）. Conclusion There are certain predictive value of AIP level for coronary heart disease. When the level of AIP is higher than 0.161, the risk of coronary heart disease is greater.