盖丽,杨玉春,木胡牙提,刘志强,何鹏义,包针

• 1:新疆医科大学第一附属医院综合心脏内科

摘要(Abstract)：

目的探讨B型脑钠肽的自然对数与左心室舒张早期流速峰值和晚期流速峰值之比的乘积(ln BNP×E/A)对冠心病与冠状动脉病变程度相关性的评估价值。方法回顾性连续收集2018年10月至2019年10月新疆医科大学第一附属医院因胸闷、胸痛等类似心绞痛症状及既往有冠心病病史的患者741例。所有患者均行冠状动脉造影,将其中造影提示血管直径狭窄≥50%诊断为冠心病者设为冠心病组(561例),正常或血管直径狭窄<50%的患者设为对照组(180例)。采用logistic回归分析冠心病的独立影响因素,并通过受试者工作特征曲线(ROC)及曲线下面积(AUC)评估lnBNP×E/A筛查冠心病的价值。临床指标与冠状动脉病变程度(Gensini评分)的相关性采用Spearman相关性分析。结果 Logistic回归分析结果显示,lnBNP×E/A与冠心病独立相关(OR 2.961,95%CI 1.744～5.025,P<0.001),差异有统计学意义;Gensini评分与lnBNP×E/A(r=0.559,P<0.001)、B型脑钠肽(r=0.253,P<0.001)、左心室舒张早期流速峰值与晚期流速峰值之比(E/A)(r=0.361,P<0.001)显著正相关。以lnBNP×E/A及冠心病与否绘制的ROC曲线显示,AUC为0.823(95%CI 0.783～0.863,P<0.001);当lnBNP×E/A>2.473时,患者可能存在冠心病(敏感度为87.7%,特异度为66.7%)。结论lnBNP×E/A与冠心病独立相关,与Gensini评分存在显著正相关性,对于冠心病的筛查及冠状动脉病变程度的评估具有一定的参考价值。

关键词(KeyWords)： 冠心病;Gensini评分;冠状动脉病变

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 盖丽,杨玉春,木胡牙提,刘志强,何鹏义,包针

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