hs-CRP/ALB、LDL-C/HDL-C与冠状动脉病变程度的相关性研究

Correlation between hs-CRP/ALB, LDL-C/HDL-C and the Degree of Coronary Artery Lesions

目的:探讨血清超敏C反应蛋白/白蛋白(hs-CRP/ALB)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(LDL-C/HDL-C)与冠状动脉(冠脉)病变程度的相关性。方法:回顾性分析2020年10月-2021年6月因胸痛症状于锦州市中心医院行冠脉造影的211例患者的临床资料,根据造影结果将患者分为冠脉正常组(n=64)和冠心病组(n=147),并通过Gensini积分进一步将冠心病组分为两个亚组,冠脉轻度病变亚组(Gensini积分<30分)55例和冠脉重度病变亚组(Gensini积分≥30分)92例。比较冠脉正常组和冠心病组的hs-CRP、ALB、LDL-C、HDL-C等指标;比较冠脉轻度病变亚组和冠脉重度病变亚组的hs-CRP、ALB、LDL-C、HDL-C等指标。分析冠心病和冠脉重度病变的影响因素;分析LDL-C/HDL-C和hs-CRP/ALB与冠脉病变程度的相关性;采用受试者工作特征曲线(ROC曲线)分析LDL-C/HDL-C和hs-CRP/ALB诊断冠脉重度病变的价值。结果:多因素logistic回归分析结果显示,hs-CRP/ALB、LDL-C/HDL-C、年龄、吸烟史、糖尿病史均为冠心病及冠脉重度病变的独立危险因素(P<0.05)。Spearman相关性分析结果显示,hs-CRP/ALB、LDL-C/HDL-C均与Gensini积分呈正相关(r;=0.576、0.367,P<0.001)。ROC分析结果显示,hs-CRP/ALB、LDL-C/HDL-C及二者联合诊断冠脉重度病变的AUC分别为0.786、0.666、0.832。结论:hs-CRP/ALB及LDL-C/HDL-C升高能够诊断冠状动脉重度病变,且二者联合的诊断价值优于任一单项指标,对冠心病的诊断和病情评估有一定临床价值。

Objective:To explore the correlation between serum hypersensitivity C reactive protein/albumin (hs-CRP/ALB),low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C) and the degree of coronary artery (coronary) lesions.Method:The clinical data of 211 patients undergoing coronary angiography due to chest pain in Jinzhou Central Hospital from October 2020 to June 2021 were retrospectively analyzed.According to the angiography results,the patients were divided into normal coronary artery group (n=64) and coronary artery disease group (n=147),and the coronary artery disease group was further divided into two subgroups by Gensini score,there were 55 patients with mild coronary artery disease subgroup (Gensini score <30 scores) and 92 patients with severe coronary artery disease subgroup (Gensini score ≥30 scores).hs-CRP,ALB,LDL-C,HDL-C and other indicators were compared between normal coronary artery group and coronary artery disease group;hs-CRP,ALB,LDL-C,HDL-C and other indicators of mild coronary artery disease subgroup and severe coronary artery disease subgroup were compared;the influencing factors of coronary heart disease and severe coronary artery disease were analyzed;the correlation between LDL-C/HDL-C and hs-CRP /ALB and the degree of coronary artery disease was analyzed;receiver operating characteristic curve (ROC) was used to analyze the value of LDL-C/HDL-C and hs-CRP /ALB in the diagnosis of severe coronary artery disease.Result:Multivariate logistic regression analysis showed that hs-CRP/ALB,LDL-C/HDL-C,age,smoking history and diabetes mellitus were independent risk factors for coronary heart disease and severe coronary artery disease (P<0.05).Spearman correlation analysis showed that hs-CRP/ALB,LDL-C/HDL-C were positively correlated with Gensini score (r;=0.576,0.367,P<0.001).ROC analysis showed that the AUC of hs-CRP/ALB,LDL-C/HDL-C and their combination in the diagnosis of severe coronary artery lesions were 0.786,0.666 and 0.832,respectively.Conclusion:Higher hs-CRP/ALB and LDL-C /HDL-C can diagnose severe coronary lesions,and the combined diagnostic value is better than any single index,which has some clinical value to the diagnosis and evaluation of coronary heart disease.