胱抑素C联合颈动脉斑块评分提高胸痛者严重冠心病的预测能力

发布时间：2018-12-16 19:05

【摘要】：目的:利用血浆胱抑素C浓度(Cyst-C)、颈动脉斑块评分(PS)预测胸痛患者严重冠心病(SCAD)的存在。方法:按入选标准回顾性收集192例胸痛患者,根据冠脉造影结果分为SCAD组(共128例)和非严重冠心病(NSCAD)组(共64例),统计分析Cyst-C与PS同SCAD的关系及对其预测能力。结果:Logistic回归分析提示Cyst-C、PS是SCAD的独立预测因子,Cyst-C每增加1 mg/L,PS每增加1 mm,其优势比(OR)分别是1.329与1.197。受试者工作(ROC)曲线分析提示以Cyst-C、PS预测SCAD的曲线下面积(AUC)分别是0.654与0.688,联合两者可提高AUC至0.742,与Cyst-C及PS单项的AUC相比,差异均有统计学意义(P值分别是0.046,0.004)。Cyst-C、PS的最佳截断点分别是0.95 mg/L、3 mm,其对SCAD预测的敏感性分别是72.3%,70.7%;阴性预测值分别是46.3%,48.3%;联合两者,敏感性与阴性预测值均增高(分别是83.6%,62.5%)。结论:Cyst-C及PS与SCAD相关,均是胸痛者SCAD的独立预测因子,联合两者能提高预测能力,增加心导管术前筛查SCAD的可靠性。
[Abstract]:Aim: to predict the presence of severe coronary heart disease (SCAD) in patients with chest pain by using plasma cystatin C (Cyst-C) and carotid plaque score (PS). Methods: 192 patients with chest pain were divided into SCAD group (128 cases) and non-severe coronary heart disease (NSCAD) group (64 cases) according to the results of coronary angiography. The relationship between Cyst-C, PS and SCAD and their predictive ability were analyzed statistically. Results: Logistic regression analysis showed that Cyst-C,PS was an independent predictor of SCAD, and the ratio of (OR) to (OR) for each increase of 1 mg/L,PS in Cyst-C was 1.329 and 1.197, respectively. The analysis of the operating (ROC) curve showed that the area under the SCAD curve predicted by Cyst-C,PS was 0.654 and 0.688 respectively, and the combination of the two could increase the AUC to 0.742.Compared with the AUC of Cyst-C and PS. The best cut-off point of Cyst-C,PS was 0.95 mg/L,3 mm,. The sensitivity to SCAD prediction was 72.3% and 70.7%, respectively. The negative predictive values were 46.3% and 48.3% respectively, and the sensitivity and negative predictive values were both increased (83.6% and 62.5%, respectively). Conclusion: Cyst-C, PS and SCAD are independent predictors of SCAD in patients with chest pain. The combination of them can improve the predictive ability and increase the reliability of SCAD screening before cardiac catheterization.
【作者单位】：南方医科大学珠江医院心血管内科;
【基金】：广东省自然科学基金(编号:2015A030313238) 广东省科技计划项目(编号:2014A020223044)
【分类号】：R541.4

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