摘要
[目的]探讨慢性冠脉综合征(CCS)患者血浆动脉硬化指数(AIP)和甘油三酯葡萄糖乘积(TyG)指数与其严重程度的相关性。[方法]回顾性选取2017年5月—2023年5月就诊于兰州大学第一医院心内科行冠状动脉造影检查确诊为CCS的患者298例,收集临床指标,根据冠状动脉造影结果计算Gensini积分,比较不同Gensini积分组的临床资料,线性回归分析Gensini积分升高的影响因素,受试者工作特征(ROC)曲线判断AIP和TyG指数对CCS患者冠状动脉病变严重程度的预测价值。[结果]该人群男性占77.9%,平均年龄(61.9±8.0)岁;Gensini高积分组的校正AIP(aAIP)和TyG指数高于低积分组和中积分组,差异具有显著性;线性回归分析显示总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、aAIP和TyG指数是Gensini积分升高的影响因素(均P<0.05);相关分析显示aAIP和TyG指数与左心室射血分数(LVEF)呈负相关,与Gensini积分呈正相关,与支架植入和支架植入数量呈正相关(均P<0.05);ROC曲线结果显示,aAIP阈值为1.924时预测Gensini积分≥41分的ROC曲线下面积(AUC)为0.583(95%CI 0.525~0.640),灵敏度为92.62%,特异度为25.50%,约登指数为0.181;TyG指数阈值为8.748时预测Gensini积分≥41分的AUC为0.768(95%CI 0.716~0.815),灵敏度为77.18%,特异度为67.11%,约登指数为0.443。[结论]aAIP和TyG指数与CCS患者的严重程度正相关,两者升高均可预测CCS患者冠状动脉病变严重程度,但TyG指数预测能力优于aAIP。
Aim To explore the correlation between atherogenic index of plasma(AIP),triglyceride-glucose(TyG)index and their severity in patients with chronic coronary syndrome(CCS).Methods A total of 298 patients diagnosed with CCS by coronary angiography were retrospectively selected from Cardiology Department of the First Hospital of Lanzhou University,from May 2017 to May 2023.Clinical indexes were collected and Gensini scores were calculated based on the results of the coronary angiography,clinical data of different Gensini integral groups was compared.Linear regression was used to analyze factors that influence the elevation of Gensini scores,and receiver operator characteristic(ROC)curve was used to determine the predictive value of AIP and TyG index for the severity of coronary artery lesions in CCS.Results The research sample consisted mostly of males(77.9%)with a mean age of(61.9±8.0)years.The adjusted AIP(aAIP)and TyG index of high Gensini score group were higher than those of low Gensini score group and medium Gensini score group,and the differences were significant.Linear regression analysis revealed that total cholesterol(TC),high density lipoprotein cholesterol(HDLC),aAIP and TyG index were the factors influencing the elevated Gensini scores(all P<0.05).Correlation analysis revealed that aAIP and TyG index were negatively correlated with left ventricular ejection fraction(LVEF),positively correlated with Gensini scores,and positively correlated with stent implantation and the number of stent implantation(all P<0.05).The ROC curve results indicated that when the aAIP threshold was 1.924,the area under the ROC curve(AUC)for predicting Gensini score≥41 points was 0.583(95%CI 0.525~0.640),with a sensitivity of 92.62%,a specificity of 25.50%,and Yoden index of 0.181.When the TyG index threshold was 8.748,the AUC for predicting Gensini score≥41 points was 0.768(95%CI 0.716~0.815),with a sensitivity of 77.18%,specificity of 67.11%,and Yoden index of 0.443.Conclusion The aAIP and TyG index were positively correlated with the severity of coronary artery disease in CCS patients.Both elevated levels can predict the severity of coronary lesions in CCS patients,but TyG index showed superior predictive ability compared with aAIP.
作者
牛镜磊
张丽霞
白明
NIU Jinglei;ZHANG Lixia;BAI Ming(Department of Cardiology,the First Hospital of Lanzhou University,Lanzhou,Gansu 730000,China)
出处
《中国动脉硬化杂志》
CAS
2024年第7期590-596,共7页
Chinese Journal of Arteriosclerosis
基金
甘肃省自然科学基金项目(23JRRA1602)。