作者：贵双俊，贾梦奇，刘士超，贾兴泰，李铮，简立国

单位：

450002河南省郑州市，郑州大学第二附属医院心血管内科 通信作者：简立国，E-mail：jlg0909@163.com

单位（英文）：

Internal Medicine-Cardiovascular Department, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450002,China Corresponding author: JIAN Liguo, E-mail: jlg0909@163.com

关键词：

冠状动脉疾病; 冠状动脉临界病变; 单核细胞/高密度脂蛋白比值; 易损斑块; 预测;

关键词（英文）：

Coronary artery disease; Intermediate coronary stenosis; Monocyte/high-density lipoprotein ratio;Vulnerable plaque; Forecasting

中图分类号：

DOI：

10.12114/j.issn.1008-5971.2023.00.003

基金项目：

河南省医学科技攻关计划联合共建项目（LHGJ20210382）

摘要：

目的 分析单核细胞/高密度脂蛋白比值（MHR）对冠状动脉临界病变患者存在易损斑块（VP）的预测价值。方法 回顾性选取2020年10月至2021年12月就诊于郑州大学第二附属医院心血管内科的冠状动脉临界病变患者121例为研究对象。收集患者的临床资料，包括一般资料、实验室检查指标、冠状动脉造影结果、光学相干断层成像（OCT）检查结果。根据患者是否存在VP，将其分为VP组（n=62）和非VP组（n=59）。冠状动脉临界病变患者存在VP的影响因素分析采用单因素、多因素Logistic回归分析；采用ROC曲线分析低密度脂蛋白（LDL）、MHR及其联合对冠状动脉临界病变患者存在VP的预测价值。结果 VP组高密度脂蛋白（HDL）低于非VP组，LDL、MHR高于非VP组（P<0.05）。单因素Logistic回归分析结果显示，LDL、MHR是冠状动脉临界病变患者存在VP的影响因素（P<0.05）。多因素Logistic回归分析结果显示，LDL、MHR是冠状动脉临界病变患者存在VP的独立影响因素（P<0.05）。ROC曲线分析结果显示，LDL、MHR及其联合预测冠状动脉临界病变患者存在VP的AUC分别为0.652[95%CI(0.553,0.756)]、0.690[95%CI(0.596,0.785)]、0.727[95%CI(0.638,0.817)]，最佳截断值分别为1.97 mmol/L、0.53、0.50，灵敏度分别为0.806、0.871、0.710，特异度分别为0.508、0.492、0.661。结论MHR对冠状动脉临界病变患者存在VP有一定预测价值，而联合LDL可提高其预测价值。

英文摘要：

【Abstract】 Objective To analyze the predictive value of monocyte/high-density lipoprotein ratio (MHR) for vulnerable plaque (VP) in patients with intermediate coronary stenosis. Methods A total of 121 patients with intermediate coronary stenosis admitted to the Internal Medicine-Cardiovascular Department, the Second Affiliated Hospital of Zhengzhou University from October 2020 to December 2021 were retrospectively selected as the study objects. Clinical data of patients were collected, including general data, laboratory examination indexes, coronary angiography results, and optical coherence tomography (OCT) examination results. According to the presence or absence of VP, patients were divided into VP group (n=62) and non VP group (n=59) . The influencing factors of VP in patients with intermediate coronary stenosis were analyzed by univariate and multivariate Logistic regression analysis. ROC curve was used to analyze the predictive value of low density lipoprotein (LDL) , MHR and their combination for VP in patients with intermediate coronary stenosis. Results The high density lipoprotein (HDL) of VP group was lower than that of non-VP group, and the LDL and MHR of VP group were higher than those of non-VP group ( P < 0.05) . Univariate Logistic regression analysis showed that LDL and MHR were influencing factors for VP in patients with intermediate coronary stenosis (P < 0.05) . Multivariate Logistic regression analysis showed that LDL and MHR were independent influencing factors for VP in patients with intermediate coronary stenosis (P < 0.05) . The ROC curve analysis results showed that the AUC of LDL, MHR and their combination in predicting VP in patients with intermediate coronary stenosis were 0.652 [95%CI (0.553, 0.756) ] , 0.690 [95%CI (0.596, 0.785) ] , 0.727 [95%CI (0.638, 0.817) ] , the best cutoff values were 1.97 mmol/L, 0.53, 0.50, the sensitivity was 0.806, 0.871, 0.710, and the specificity was 0.508, 0.492, 0.661, respectively. Conclusion MHR has a certain predictive value for VP in patients with intermediate coronary stenosis, while the combination of LDL can improve its predictive value.

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