摘要
目的探究CT血流储备分数(CT-FFR)、三酰甘油-葡萄糖(TyG)指数和中性粒细胞与淋巴细胞比值(NLR)对老年冠心病(CHD)患者冠状动脉狭窄程度的评估价值。方法回顾性选取2021年1月至2024年10月皖南医学院弋矶山医院收治的老年CHD患者80例,根据Gensini评分分为轻度组(42例)、中重度组(38例)。比较两组患者一般资料、CT血管造影参数、血脂水平、TyG指数、炎症指标水平,分析老年CHD患者CT-FFR、TyG指数、NLR与Gensini评分、冠状动脉钙化(CAC)积分的相关性;绘制受试者工作特征(ROC)曲线,分析CT-FFR、TyG、NLR联合检测对老年CHD患者冠状动脉狭窄程度的评估价值;多因素Logistic回归分析老年CHD患者冠状动脉狭窄程度的影响因素。结果中重度组患者Gensini评分、CAC积分、冠状动脉狭窄程度、TyG指数、NLR显著高于轻度组(P<0.05),CT-FFR显著低于轻度组(P<0.05)。CT-FFR与Gensini评分、CAC积分呈负相关(P<0.05),TyG指数、NLR与Gensini评分、CAC积分呈正相关(P<0.05);CT-FFR、TyG、NLR联合检测评估老年CHD患者冠状动脉狭窄程度的曲线下面积(AUC)为0.900,灵敏度为0.816,特异度为0.905,约登指数为0.721,均高于单项指标检测;高TyG指数、NLR、CAC积分均是老年CHD患者冠状动脉狭窄程度的危险因素(P<0.05),高CT-FFR是其保护因素(P<0.05)。结论CT-FFR、TyG指数和NLR在评估老年CHD患者冠状动脉狭窄程度方面具有较高的价值,且CT-FFR与Gensini评分、CAC积分呈负相关,TyG指数、NLR与Gensini评分、CAC积分呈正相关,三者联合检测能够帮助临床更全面地评估老年CHD患者病情,为治疗提供指导。
Objective To investigate the value of CT-derived fractional flow reserve(CT-FFR),triglyceride-glucose(TyG)index,and neutrophil-to-lymphocyte ratio(NLR)in evaluating the degree of coronary artery stenosis in elderly patients with coronary heart disease(CHD).Methods A retrospective study included 80 elderly CHD patients admitted to Yijishan Hospital of Wannan Medical College from January 2021 to October 2024.Patients were classified into a mild group(n=42)and a moderate-to-severe group(n=38)based on Gensini scores.General data,CT angiography parameters,blood lipid levels,TyG index,and inflammatory markers were compared between groups.Correlations of CT-FFR,TyG index,and NLR with Gensini scores and coronary artery calcification(CAC)scores were analyzed.Receiver operating characteristic(ROC)curves were plotted to evaluate the combined utility of CT-FFR,TyG,and NLR in assessing coronary stenosis severity.Multivariate logistic regression identified factors influencing stenosis severity.Results The moderate-to-severe group had significantly higher Gensini scores,CAC scores,coronary stenosis severity,TyG index,and NLR(P<0.05),but lower CT-FFR than the mild group(P<0.05).CT-FFR showed negative correlations with Gensini and CAC scores,while TyG index and NLR showed positive correlations(P<0.05).The combined detection of CT-FFR,TyG,and NLR yielded an AUC of 0.900 for evaluating stenosis severity,with sensitivity 0.816,specificity 0.905,and Youden index 0.721-all superior to individual markers.High TyG index,NLR,and CAC scores were independent risk factors for severe stenosis(P<0.05),whereas high CT-FFR was a protective factor(P<0.05).Conclusion CT-FFR,TyG index,and NLR demonstrate high clinical value in assessing coronary stenosis severity in elderly CHD patients.CT-FFR negatively correlates with Gensini and CAC scores,while TyG index and NLR show positive correlations.Combined assessment of these markers provides comprehensive guidance for clinical management.
作者
潘大彬
潘健源
查林涛
凌洋
胡思思
左权
PAN Dabin;PAN Jianyuan;ZHA Lintao;LING Yang;HU Sisi;ZUO Quan(Department of Cardiology,Yijishan Hospital Affiliated Wannan Medical College,Wuhu,Anhui 241001,China;Department of Cardiovascular Medicine,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230036,China)
出处
《转化医学杂志》
2025年第8期63-67,共5页
Translational Medicine Journal
基金
安徽省教育厅安徽省高等学校科学研究项目(2024AH040261)。
关键词
冠心病
CT血流储备分数
血脂
三酰甘油-葡萄糖指数
中性粒细胞与淋巴细胞比值
冠状动脉狭窄程度
coronary heart disease
CT myocardial perfusion reserve index
blood lipids,triglyceride-glucose index
neutrophil to lymphocyte ratio
degree of coronary artery stenosis
