血清TBIL、Hcy、hs-CRP、UA水平与老年冠心病病人冠状动脉不稳定性斑块形成间的关系

Relationship between serum TBIL,Hcy,hs-CRP,UA and unstable coronary plaque formation in elderly patients with coronary heart disease

目的探讨血清总胆红素(TBIL)、Hcy、hs-CRP、UA与老年CHD病人冠状动脉不稳定性斑块形成的关系。方法选取2019年4月至2021年4月我院收治的198例CHD病人为研究对象,依据颈动脉多普勒超声检查结果分为不稳定组(n=54)与稳定组(n=144)。对比2组基线资料信息及血清学指标水平,将有统计学意义的变量纳入多因素Logistic回归分析,明确老年CHD病人冠状动脉不稳定性斑块形成的危险因素。结果2组性别、年龄、BMI、心率(HR)、SBP、DBP、高血压史、糖尿病史、吸烟史、饮酒史及血清TC、TG、LDL-C、HDL-C水平比较,差异无统计学意义(P>0.05);不稳定组血清TBIL水平显著低于稳定组(P<0.05),血清Hcy、hs-CRP、UA水平显著高于稳定组(P<0.05)。ROC曲线分析显示,血清TBIL、Hcy、hs-CRP、UA均能用于老年CHD病人冠状动脉不稳定性斑块形成的预测,AUC分别为0.956、0.647、0.870、0.842(均P<0.05)。多因素Logistic回归分析表明,血清TBIL≤7.985μmol/L、Hcy≥12.725μmol/L、hs-CRP≥3.895 mg/L、UA≥340.645μmol/L为老年CHD病人冠状动脉不稳定性斑块形成的危险因素(均P<0.05)。结论老年CHD病人冠状动脉不稳定性斑块形成与血清TBIL、Hcy、hs-CRP、UA水平关系密切,TBIL≤7.985μmol/L、Hcy≥12.725μmol/L、hs-CRP≥3.895 mg/L、UA≥340.645μmol/L是预测病人冠状动脉不稳定性斑块形成的最佳截断值,值得临床医师关注。

Objective To investigate the relationship between serum total bilirubin(TBIL),homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP),uric acid(UA)and unstable coronary plaque formation in the elderly patients with coronary heart disease(CHD).Methods A total of 198 patients with CHD admitted to our hospital from April 2019 to April 2021 were enrolled in the study,and they were divided into the unstable group(n=54)and the stable group(n=144).The baseline data and serum indexes of the two groups were compared,and multivariate Logistic regression analysis was used to clarify the risk factors of unstable coronary plaque formation in the elderly patients with CHD.Results The level of serum TBIL in the unstable group was significantly lower than that in the stable group(P<0.05).The levels of serum Hcy,hs-CRP and UA in the unstable group were significantly higher than those in the stable group(P<0.05).Receiver operating characterise curve analysis confirmed that serum TBIL,Hcy,hs-CRP and UA could be used to predict the formation of unstable coronary plaque in the elderly patients with CHD,with an AUC of 0.956,0.647,0.870 and 0.842,respectively(P<0.05).Multivariate Logistic regression analysis confirmed that serum TBIL≤7.985μmol/L,Hcy≥12.725μmol/L,hs-CRP≥3.895 mg/L and UA≥340.645μmol/L were the risk factors for coronary unstable plaque formation in the elderly patients with CHD(P<0.05).Conclusions The formation of unstable coronary plaque in the elderly patients with CHD is closely related to the expression of serum TBIL,Hcy,hs-CRP and UA.TBIL≤7.985μmol/L,Hcy≥12.725μmol/L,hs-CRP≥3.895 mg/L,UA≥340.645μmol/L are the best cut-off values for predicting the formation of unstable coronary plaque.