[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()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2008年03期
页码:
155
栏目:
心脏介入
出版日期:
2008-03-15

文章信息/Info

Title:
Value of multiple risk factors in predicting coronary artery disease
作者:
朱政斌张瑞岩张奇
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):
ZHU Zheng-binZHANG Rui-yanZHANG Qi YANG Zhen-kunHU JianZHANG Jian-shengSHEN Wei-feng
Ruijin Hospital,School of Medicine Jiaotong University,Shanghai200025,China
关键词:
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:
R541.4
文献标志码:
A
摘要:
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:
收稿日期:2007-10-08
更新日期/Last Update: 2008-03-15