TG/HDL-C比值与冠状动脉微循环疾病的相关性研究

The relationship between triglyceride/high-density lipoprotein cholesterol ratio and the occurrence of coronary microvascular disease

目的:探究甘油三酯(TG)与高密度脂蛋白胆固醇(HDL-C)比值与冠状动脉微循环疾病(CMVD)的相关性。方法:连续入选2019年9月—2020年6月就诊于我院的252例有心绞痛症状但冠状动脉(冠脉)造影正常或轻度狭窄(<50%)的患者,行冠脉血流储备分数检查(CFR),按照CFR结果是否大于2,分为A组(CMVD组,CFR≤2)164例和B组(非CMVD组,CFR>2)88例,比较两组临床基本资料的差异;采用多因素Logistic回归分析患者发生CMVD的危险因素;通过绘制ROC曲线寻找较好的预测CMVD发生的指标。结果:与B组比较,A组患者中吸烟者比例明显增高,TG浓度、TG/HDL-C比值、血小板计数明显增高;HDL-C浓度、白蛋白浓度明显降低(P<0.05)。经过多因素Logistic回归分析可知,TG/HDL-C比值、TG、白蛋白是CMVD发生的独立危险因素(P<0.05);通过绘制ROC曲线显示,TG、TG/HDL-C预测CMVD发生的ROC曲线下面积(AUC)为0.709(95%CI:0.644~0.775)、0.715(95%CI:0.649~0.780)。结论:TG/HDL-C比值是CMVD发生的独立危险因素。

Objective: To explore the relationship between triglyceride/highdensity lipoprotein cholesterol ratio and the occurrence of coronary microvascular disease(CMVD). Methods: The 252 patients with angina symptoms and normal coronary angiography or without obvious coronary stenosis were enrolled in our hospital from September 2019 to June 2020. CMVD was diagnosed by coronary flow reserve(CFR). According to the CFR, 164 patients were in group A(CMVD group, CFR≤2), and 88 patients in group B(non-CMVD group, CFR>2). The differences were compared in baseline clinical characteristics, triglyceride/high-density lipoprotein cholesterol ratio between the two groups. And the significative influencing factors of CMVD were analyzed by multivariate Logistic regression. The operating characteristic curve(ROC) was drawn to evaluate the predictive of influencing factors. Results: Compared with group B, the proportion of smoking was significantly increased in group A(P<0.05). Triglyceride, triglyceride/high-density lipoprotein cholesterol, blood platelet were significantly increased in group A(P<0.05), but albumin, high-densitylipoprotein cholesterol was decreased in group A(P<0.05). From multivariate logistic regression analysis, triglyceride, triglyceride/high-density lipoprotein cholesterol and albumin were all independent factors for patients(P<0.01). ROC curve showed that the area under ROC curve of TG and TG/HDL-C in predicting CMVD was 0.709(95%CI 0.644-0.775) and 0.715(95%CI 0.649-0.780). Conclusion: Triglyceride/high-density lipoprotein is an independent risk factor of the CMVD.