[1]朱政斌,张瑞岩,张奇,等.综合危险因素预测稳定型心绞痛患者冠状动脉病变[J].介入放射学杂志,2008,(03):155.
ZHU Zhengbin,ZHANG Ruiyan,ZHANG Qi,et al.Value of multiple risk factors in predicting coronary artery disease[J].journal interventional radiology,2008,(03):155.
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综合危险因素预测稳定型心绞痛患者冠状动脉病变()
《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
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- 期数:
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2008年03期
- 页码:
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155
- 栏目:
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心脏介入
- 出版日期:
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2008-03-15
文章信息/Info
- Title:
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Value of multiple risk factors in predicting coronary artery disease
- 作者:
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朱政斌; 张瑞岩; 张奇; 等
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200025上海交通大学医学院附属瑞金医院心脏科通讯作者:张瑞岩
- Author(s):
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ZHU Zheng-bin; ZHANG Rui-yan; ZHANG Qi ; YANG Zhen-kun; HU Jian; ZHANG Jian-sheng; SHEN Wei-feng
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Ruijin Hospital,School of Medicine Jiaotong University,Shanghai200025,China
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- 关键词:
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冠状动脉粥样硬化; 冠状动脉介入诊治; 肾小球滤过率; 微量尿蛋白; 炎症因子
- 分类号:
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R541.4
- 文献标志码:
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A
- 摘要:
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目的分析肾功能损害等危险因素对稳定性心绞痛患者冠状动脉(冠脉)病变程度的相关性,并建立评估冠脉病变的数学模型。方法1024例行冠脉造影患者分为病变组(625例)和对照组(399例),评估肾功能损害等冠心病的临床危险因素,以Logistic回归结合ROC曲线分析其与冠脉病变的相关性,并建立评估冠脉病变的回归模型。结果回归分析显示尿蛋白∶肌酐比值>7.25μg /mg (OR=3.6;95%CI 2.6~4.9;P<0.001),超敏C反应蛋白(hsCRP)>20mmol/L(OR=3.2;95%CI 2.3~4.4;P<0.01),GFR<60ml/min·1.73m
2
(OR=2.3;95%CI 1.4~3.8;P<0.01),左室射血分数(LVEF)<50%(OR=2.3;95%CI 1.4~3.6;P<0.01),低密度脂蛋白>2.6mmol/L(OR=2.1;95%CI 1.6~2.9;P<0.01),吸烟史(OR=2.0;95%CI 1.4~2.8;P<0.01),男性(OR=1.8;95%CI 1.2~2.6;P=0.002),糖尿病(OR=1.6;95%CI 1.1~2.4;P<0.05)及高血压(OR=1.5;95%CI 1.1~2.1;P<0.01)为冠脉病变相关的独立因素。建立评估冠脉病变回归模型:P/(1-P)=EXP(-2.453+1.270×尿蛋白∶肌酐比值>7.25μg /mg +1.158×hsCRP>20mmol/L+0.819×GFR<60ml/min·1.73m
2
+0.813×LVEF<50%+0.761×低密度脂蛋白>2.6mmol/L+0.676×吸烟史+0.594×男性+0.459×糖尿病+0.425×高血压)。ROC曲线下面积0.811,切点为0.977,灵敏度49.0%,特异度92.7%。结论肾功能损害等危险因素与冠脉病变显著相关。Logistic回归模型对无创评估冠脉病变有一定的临床实用价值。
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备注/Memo
- 备注/Memo:
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收稿日期:2007-10-08
更新日期/Last Update:
2008-03-15