NHHR与急性冠脉综合征合并2型糖尿病患者冠脉多支病变的相关性研究OA
Association Between the Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio and Multivessel Coronary Artery Disease in Patients With Acute Coronary Syndrome and Type 2 Diabetes Mellitus
目的 探讨非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(NHHR)与急性冠脉综合征(ACS)合并 2 型糖尿病(T2DM)患者冠状动脉多支病变(MVD)的相关性,并评估其对冠状动脉MVD的预测价值.方法 选取 2022年1月至2024 年12月武汉市第三医院收治的 378例ACS合并T2DM患者,根据其造影结果,分为单支病变组(SVD,111 例)与多支病变组(MVD,267 例).比较两组患者在临床资料、生化指标及NHHR指数的差异.使用Spearman相关性分析评估NHHR与多支病变的相关性;使用多因素Logistic回归寻找该类患者发生多支病变的独立相关因素;绘制受试者工作曲线(ROC)评估NHHR对该类人群发生多支病变的预测效能.结果 两组人群在性别、空腹血糖(FPG)、白细胞(WBC)、中性粒细胞(N)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血小板(PLT)、NHHR、糖化血红蛋白(HbA1C)比较,差异有统计学意义(P＜0.05).其中多因素回归分析后,高水平NHHR和HbA1C是ACS合并T2DM患者发生MVD的独立相关因素.ROC曲线显示,NHHR预测ACS合并T2DM患者发生MVD的曲线下面积(AUC)为 0.727,灵敏度值为 0.588,特异度值为 0.802.HbA1C预测ACS合并T2DM患者发生MVD的曲线下面积(AUC)为 0.677,灵敏度值为 0.442,特异度值为 0.847.两者联合预测ACS合并T2DM患者发生MVD的曲线下面积(AUC)为 0.758,灵敏度值为 0.760,特异度值为 0.649.结论 NHHR与ACS合并T2DM患者发生MVD呈正相关,并对该类患者发生多支病变具有一定预测价值,且与HbA1C进行联合预测时,其预测价值均高于单项指标预测价值.
Objective To investigate the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio(NHHR)and multivessel coronary artery disease(MVD)in patients with acute coronary syndrome(ACS)complicated by type 2 diabetes mellitus(T2DM).and to evaluate its predictive value for coronary MVD.Methods A total of 378 patients with ACS and concomitant T2DM who were admitted to Wuhan Third Hospital between January 2022 and December 2024 were enrolled.Based on coronary angiography findings.the patients were divided into a single-vessel disease group(SVD.n=111)and a multivessel disease group(MVD.n=267).Differences in clinical characteristics.biochemical indices.and NHHR between the two groups were compared.Spearman correlation analysis was used to assess the correlation between NHHR and MVD.Multivariable logistic regression was performed to identify independent factors associated with MVD in this population.Receiver operating characteristic(ROC)curves were generated to evaluate the predictive performance of NHHR for MVD.Results Significant between-group differences were observed in sex.fasting plasma glucose(FPG).white blood cell count(WBC).neutrophil count(N).total cholesterol(TC).triglycerides(TG).high-density lipoprotein cholesterol(HDL-C).low-density lipoprotein cholesterol(LDL-C).platelet count(PLT).NHHR.and hemoglobin A1c(HbA1c)(P＜0.05).Multivariable regression analysis showed that a high NHHR(OR=2.268.95%CI 1.533～3.355.P＜0.001)and HbA1c(OR=1.551.95%CI 1.215～1.979.P＜0.001)were independent factors associated with MVD in patients with ACS and T2DM.ROC analysis showed that NHHR predicted MVD with an area under the curve(AUC)of 0.727.a sensitivity of 0.588.and a specificity of 0.802.HbA1c predicted MVD with an AUC of 0.677.a sensitivity of 0.442.and a specificity of 0.847.The combined model of NHHR and HbA1c yielded an AUC of 0.758.with a sensitivity of 0.760 and a specificity of 0.649.Conclusion NHHR is positively correlated with the presence of MVD in patients with ACS complicated by T2DM and shows certain predictive value for multivessel disease.When combined with HbA1c.its predictive performance is higher than that of either indicator alone.
邱睿;李子衿;李东升
江汉大学 医学部,湖北 武汉 430056||武汉市第三医院(武汉大学同仁医院) 心血管内科,湖北 武汉 430060江汉大学 医学部,湖北 武汉 430056||武汉市第三医院(武汉大学同仁医院) 心血管内科,湖北 武汉 430060武汉市第三医院(武汉大学同仁医院) 心血管内科,湖北 武汉 430060
医药卫生
急性冠脉综合征2型糖尿病非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值多支病变
acute coronary syndrometype 2 diabetes mellitusnon-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratiomultivessel disease
《临床研究》 2026 (2)
1-5,5
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