The value of atherogenic index of plasma in predicting premature coronary artery disease
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摘要: 目的:比较血脂相关指标对早发冠心病的预测价值,探讨血浆致动脉硬化指数(AIP)预测早发冠心病的可行性。方法:收集因胸痛发作疑诊冠心病,于我院行冠状动脉造影(CAG)且男性<55岁、女性<65岁的患者240例,经CAG确诊早发冠心病组160例,余80例未达冠心病诊断标准设为正常对照组。测定各组血脂水平并计算AIP。结果:早发冠心病组AIP水平明显高于正常对照组(P<0.05);多因素Logistic回归分析示甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及AIP均是早发冠心病的独立预测指标。AIP对早发冠心病危险性更大(OR=27.222,95%CI:5.899~125.625,P<0.001)。在AIP预测早发冠心病的ROC曲线中,其曲线下面积为0.766(95%CI:0.704~0.829,P<0.001),AIP诊断早发冠心病截点值为0.20(敏感性68%,特异性80%)。结论:AIP是早发冠心病的独立危险因素,可用于早发冠心病的预测,AIP较传统单项血脂指标对于预测早发冠心病的发生具有更高的临床意义。Abstract: Objective: To compare the predictive value of lipid indexes for premature coronary artery disease(PCHD), and to evaluate the feasibility of AIP in predicting PCHD. Method: A total of 240 patients with suspected coronary artery disease(CHD) due to chest pain with male<55 years old or female<65 years old were enrolled in the study. All patients received coronary angiography(CAG), 160 cases of them were confirmed PCHD and the remaining 80 cases were as normal control group. The lipid levels were measured. Result: The levels of AIP in the PCHD group were significantly higher than those in the control group(P<0.05). Multivariate logistic regression analyses revealed that TG, TC, HDL-C, LDL-C and AIP were independent predictors of PCHD. AIP was associated with PCHD(OR=27.222, 95%CI: 5.899~125.625, P<0.001). Area under the ROC curve for AIP in evaluating prognosis of PCHD were 0.766(95%CI: 0.704~0.829, P<0.001). The optimal cut-off value of AIP to diagnose PCHD was 0.20 with a sensitivity of 68% and specificity of 80%.Conclusion: AIP is an independent risk factor for PCHD, and it can be used to predict for PCHD.
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