C反应蛋白/白蛋白比值与冠状动脉微血管型心绞痛的相关性研究

Correlation between C-reactive protein to albumin ratio and microvascular angina

目的探讨C反应蛋白(CRP)/白蛋白(ALB)比值(CAR)与微血管型心绞痛(MVA)的相关性,并评估CAR对MVA的预测价值。方法选取2022年9月至2023年12月于大连医科大学附属第二医院心血管内科因胸痛住院且明确诊断为MVA的64例患者作为MVA组,随机选取同期行冠状动脉造影检查示冠状动脉正常或狭窄<50%,且运动平板试验呈阴性的68例患者为对照组。检测两组患者的血清CRP、ALB等指标,计算CAR,并采用多因素Logistic回归分析、Pearson相关性分析及受试工作者特征(ROC)曲线分析MVA患者的独立危险因素。结果MVA组与对照组相比,CRP和CAR水平明显升高,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高CAR水平(OR=2.416,95%CI:2.234~2.624,P<0.001)、高CRP水平(OR=2.124,95%CI:1.471~3.067,P<0.001)是MVA发生的独立危险因素,且随着CAR、CRP水平增加,患者发生MVA的风险增加。ROC曲线分析结果显示,AUC=0.762,95%CI:0.681~0.843,CAR预测MVA的最佳截断值是12.02 ng/ml,敏感性为68.4%,特异性为97.1%。结论血清CAR可作为MVA的独立危险因素,为MVA诊断提供正向预测;血清CAR水平的测定有助于早期识别MVA患者。

Objective To investigate the correlation between C-reactive protein(CRP)to albumin(ALB)ratio(CAR)and microvascular angina(MVA),and review the predictive value of CAR to MVA.Methods The patients hospitalized due to chest pain and diagnosed as MVA(n=64)were chosen into MVA group,and patients with normal or stenosis<50%in examination of coronary angiography(CAG)and negative result of treadmill exercise test(TET,n=68)were chosen into control group from Department of Cardiovascular Medicine in the Second Affiliated Hospital of Dalian Medical University from Sept.2022 to Dec.2023.The levels of CRP and ALB were detected,and CAR was calculated.The independent risk factors were analyzed by using multi-factor Logistic regression analysis,Pearson correlation analysis and ROC curve analysis in MVA patients.Results The levels of CRP and CAR were significantly higher in MVA group than those in control group(P<0.05).The results of multi-factor Logistic regression analysis showed that higher CAR level(OR=2.416,95%CI:2.234~2.624,P<0.001)and higher CRP level(OR=2.124,95%CI:1.471~3.067,P<0.001)were independent factors for MVA occurrence,and MVA risk increased as CAR and CRP levels increased.The results of ROC curve analysis showed that AUC=0.762(95%CI:0.681~0.843)in prediction of MVA by CAR,and the optimal cutoff value was 12.02 ng/ml,sensitivity was 68.4%and specificity was 97.1%.Conclusion The level of serum CAR is an independent factor for MVA occurrence,and provide the positive prediction for MVA diagnosis.The detection of serum CAR level may be helpful for early diagnosis of MVA.