摘要
目的探讨甘油三酯-葡萄糖指数(TyG)、纤维蛋白原/白蛋白比率(FAR)以及红细胞分布宽度/血小板比率(RPR)与冠心病(CHD)患者冠状动脉病变严重性之间的相关性。方法回顾性连续纳入2024年1月至2025年1月新疆医科大学第一附属医院经冠状动脉造影(CAG)确诊的150例冠心病患者,设为观察组;另选同期CAG检查未发现冠状动脉狭窄的30例患者,设为对照组。比较两组患者的TyG、FAR及RPR水平。依据病变血管数分为单支病变组(n=42)、双支病变组(n=47)和多支病变组(n=61);根据Gensini评分分为轻度组(≤30分,n=50)、中度组(31~75分,n=50)和重度组(>75分,n=50)。比较不同病变血管数、不同严重程度患者的TyG、FAR与RPR水平。绘制受试者操作特征(ROC)曲线评价3项指标在判断冠状动脉重度病变中的预测效能。结果观察组患者的TyG、FAR及RPR水平分别为8.81±0.51、(9.42±2.03)%、(22.08±5.01)%,均明显高于对照组[4.42±0.43、(6.78±1.35)%、(13.65±5.13)%],差异均有统计学意义(P<0.05)。不同冠状动脉病变支数组患者的TyG、FAR及RPR水平比较,差异均有统计学意义(P<0.05),其中多支病变组患者的指标水平最高,单支病变组最低。不同病情严重程度患者TyG、FAR及RPR的水平比较,差异均有统计学意义(P<0.05),其中重度组患者的指标水平均最高,轻度组患者的指标水平最低。ROC曲线分析显示,TyG、FAR及RPR联合检测诊断的重度冠状动脉病变曲线下面积(AUC)为0.834,高于任一指标TyG、FAR及RPR检测的AUC(0.608、0.790、0.685)。结论TyG、FAR及RPR均可作为评价CHD患者冠状动脉病变严重程度的潜在血清学指标,具有一定的临床参考价值,尤其FAR在风险分层与早期识别重度病变方面表现出较强的应用潜力。
Objective To investigate the correlation between triglyceride-glucose index(TyG),fibrinogen-to-albumin ratio(FAR),red cell distribution width-to-platelet ratio(RPR)and the severity of coronary artery lesions in patients with coronary heart disease(CHD).Methods A total of 150 patients with coronary heart disease diagnosed by coronary angiography(CAG)in the First Affiliated Hospital of Xinjiang Medical University from January 2024 to January 2025 were retrospectively included as the observation group.Another 30 patients with no coronary artery stenosis detected by CAG were selected as the control group.The levels of TyG,FAR,and RPR were compared between the two groups.According to the number of diseased vessels,CHD patients were classified into the single-vessel disease group(n=42),the double-vessel disease group(n=47),and the multi-vessel disease group(n=61).According to the Gensini score,they were divided into the mild group(≤30 points,n=50),the moderate group(31-75 points,n=50),and the severe group(>75 points,n=50).The levels of TyG,FAR,and RPR were compared among these groups.Receiver operator characteristic(ROC)curve was plotted to evaluate the predictive value of these indicators for severe coronary artery lesions.Results The levels of TyG,FAR and RPR in the observation group were 8.81±0.51,(9.42±2.03)%and(22.08±5.01)%,respectively,which were significantly higher than those in the control group[4.42±0.43,(6.78±1.35)%and(13.65±5.13)%],the differences were statistically significant(P<0.05).There were statistically significant differences in the levels of TyG,FAR and RPR among patients with different coronary artery lesion counts(P<0.05);among them,the levels of TyG,FAR and RPR in the multi-vessel lesion group was the highest,and that in the single-vessel lesion group was the lowest.There were statistically significant differences in the levels of TyG,FAR and RPR among patients with different severity of disease(P<0.05);among them,the levels of TyG,FAR and RPR in the severe group were the highest,and those in the mild group were the lowest.ROC curve analysis showed that the area under the curve(AUC)of the combined detection of TyG,FAR and RPR in the diagnosis of severe coronary artery disease was 0.834,which was higher than that of any index TyG,FAR and RPR(0.608,0.790,0.685).Conclusion TyG,FAR,and RPR can serve as potential serological indicators for evaluating the severity of coronary artery lesions in CHD patients,with certain clinical reference value.Particularly,FAR shows strong application potential in risk stratification and early identification of severe lesions.
作者
白双
尚静
牛琴
BAI Shuang;SHANG Jing;NIU Qin(Comprehensive Internal Medicine of Cadre Health Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)
出处
《临床和实验医学杂志》
2026年第5期460-464,共5页
Journal of Clinical and Experimental Medicine
基金
2025年度新疆维吾尔自治区卫生健康保健科研专项项目(编号:BH202512)。
关键词
冠心病
冠状动脉病变
甘油三酯葡萄糖指数
纤维蛋白原/白蛋白
红细胞分布宽度/血小板
Coronary heart disease
Coronary artery lesions
Triglyceride-glucose index
Fibrinogen-to-albumin ratio
Red cell distribution width-to-platelet ratio
