摘要
目的分析残余胆固醇炎症指数(RCII)对冠心病患者冠状动脉病变程度的评估价值。方法选择2022年3月至2025年3月南京市中心医院心内科206例冠心病患者为研究对象,根据Gensini评分将患者分为轻度组(109例)、重度组(97例)。比较两组实验室指标总胆固醇、三酰甘油、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、残余胆固醇(RC)、RCII差异。构建受试者工作特征(ROC)曲线评估RCII对冠心病患者冠状动脉病变程度的评估价值。采用多因素Logistic逐步回归分析冠心病患者冠状动脉病变程度的影响因素。结果重度组三酰甘油、RC、hs-CRP、RCII均高于轻度组(P<0.05),HDL-C低于轻度组(P<0.05)。RCII评估冠心病患者冠状动脉病变程度的曲线下面积(AUC)(95%CI)为0.901(0.850~0.953),高于三酰甘油、HDL-C、RC、hs-CRP单独预测的0.632(0.582~0.683)、0.740(0.691~0.792)、0.847(0.795~0.893)、0.768(0.717~0.819)(Z=11.021、10.654、8.184、9.461,P<0.05)。重度组空腹血糖、白细胞计数、血肌酐均高于轻度组,高血压史、糖尿病史所占比例均大于轻度组,左心室射血分数(LVEF)低于轻度组(P<0.05)。多因素Logistic逐步回归分析显示,高血压(OR=2.804,95%CI:1.418~5.546)、空腹血糖升高(OR=1.982,95%CI:1.326~2.962)、RC升高(OR=2.130,95%CI:1.365~3.323)、RCII升高(OR=2.323,95%CI:1.469~3.675)是冠心病患者冠状动脉病变程度的独立危险因素(P<0.05)。结论RCII与冠心病患者冠状动脉病变程度显著相关,较单一指标可更能精准预测冠状动脉病变程度。
Objective To analyze the value of residual cholesterol inflammatory index(RCII)in assessing the degree of coronary artery lesions in patients with coronary heart disease.Methods A total of 206 patients with coronary heart disease admitted to Nanjing Central Hospital from March 2022 to March 2025 were enrolled.According to the Gensini score,patients were divided into a mild group(n=109)and a severe group(n=97).Differences in total cholesterol,triglycerides,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-CRP),RC and RCII were compared between groups.Receiver operating characteristic(ROC)curve analysis was used to evaluate RCII's value in assessing coronary lesion severity.Multivariate logistic stepwise regression analyzed influencing factors.Results Triglycerides,RC,hs-CRP and RCII were significantly higher in the severe group than in the mild group(P<0.05),while HDL-C was lower(P<0.05).The AUC(95%CI)of RCII for assessing coronary lesion severity was 0.901(0.850-0.953),significantly higher than that of triglycerides[0.632(0.582-0.683)],HDL-C[0.740(0.691-0.792)],RC[0.847(0.795-0.893)]and hs-CRP[0.768(0.717-0.819)]alone(Z=11.021,10.654,8.184,9.461;all P<0.05).Fasting blood glucose,white blood cell count,and serum creatinine were higher in the severe group,with higher proportions of hypertension and diabetes history,while left ventricular ejection fraction was lower(all P<0.05).Multivariate analysis identified hypertension(OR=2.804,95%CI:1.418-5.546),elevated fasting blood glucose(OR=1.982,95%CI:1.326-2.962),elevated RC(OR=2.130,95%CI:1.365-3.323),and elevated RCII(OR=2.323,95%CI:1.469-3.675)as independent risk factors(all P<0.05).Conclusion RCII is significantly correlated with the degree of coronary artery lesions in cases with coronary heart disease and can predict the degree of coronary artery lesions more accurately than a single indicator.
作者
佟宵月
王红霞
王婧
陈芡茹
徐艳娟
TONG Xiaoyue;WANG Hongxia;WANG Jing;CHEN Qianru;XU Yanjuan(Department of Cardiology,Nanjing Central Hospital,Nanjing,Jiangsu 210018,China)
出处
《转化医学杂志》
2025年第7期30-34,共5页
Translational Medicine Journal
基金
江苏省老年健康科研课题项目(LK2021029)。
关键词
冠心病
冠状动脉病变
残余胆固醇炎症指数
评估价值
Coronary heart disease
Coronary artery lesions
Residual cholesterol inflammatory index
Assessing value
