血糖、血脂、胱抑素C及同型半胱氨酸联合检测冠心病的价值

The Value of Blood Glucose, Lipids, Cystatin C and Homocysteine in Combining to Detect Coronary Heart Disease

摘要: 目的：探讨血糖、血脂、胱抑素C及同型半胱氨酸联合检测对冠心病的诊断价值。方法：收集2020年1月~2022年1月来我院就诊的489例冠心病患者及480例健康人群的高血压史，血糖(GLU)，肌酐(CRE)，总蛋白(TP)，甘油三酯(TG)，总胆固醇(TC)，高密度脂蛋白(HDL)，低密度脂蛋白(LDL)，脂蛋白a (Lp(a))，肌酸激酶(CK)，乳酸脱氢酶(LDH)，胱抑素C (CysC)，腺苷脱氨酶(ADA)，β羟丁酸(β-HB)，游离脂肪酸(NEFA)，视黄醇结合蛋白(RBP)，总胆汁酸(TBA)，同型半胱氨酸(HCY)和超敏C反应蛋白(hs-CRP)。单因素分析冠心病的可疑影响因素，二元logistic回归分析冠心病的独立危险因素并计算联合预测因子，并用受试者工作特征曲线(ROC)分析血糖、血脂、CysC、HCY及联合预测因子对冠心病的诊断价值。结果：经多因素二元Logistic回归分析显示血糖(OR = 1.257)、甘油三酯(OR = 1.724)、总胆固醇(OR = 1.458)、低密度脂蛋白(OR = 3.776)、Lp(a) (OR = 1.038)、胱抑素C (OR = 6.942)、游离脂肪酸(OR = 1.002)和同型半胱氨酸(OR = 1.304)是冠心病的独立危险因素，高密度脂蛋白(OR = 0.164)与冠心病的发生成负相关。Glu、TG、TC、LDL、Lp(a)、NEFA、CysC及HCY单独诊断的敏感度是0.63、0.481、0.776、0.578、0.401、0.438、0.414、0.889，特异度分别是0.619、0.81、0.583、0.692、0.875、0.794、0.954、0.637。联合预测因子的敏感度0.868，特异度0.85。结论：血糖、血脂、CysC及HCY联合预测冠心病有重要的意义，可推广用于临床。

Abstract: Objective: To explore the diagnostic value of combined detection of blood glucose, blood lipid, Cys-tatin C and homocysteine in coronary heart disease. Methods: A total of 489 patients with coronary heart disease and 480 patients in physical examination center from January 2020 to January 2022 were enrolled in this study, hypertension, fasting blood glucose (GLU), creatinine (CRE), total pro-tein (TP), triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipo-protein (LDL), lipoprotein (a) (Lp(a)), creatine kinase (CK), lactate dehydrogenase (LDH), cystatin C (CysC), adenosine deaminase (ADA), β-hydroxybutyric acid (β-HB), nonestesterified fatty acid (NEFA), retinol-binding protein (RBP), total bile acid (TBA), homocysteine (HCY) and high sensitivi-ty C-reactive protein (hs-CRP). Logistic regression analysis was used to analyze the independent risk factors of coronary heart disease and calculate the combined predictors. Receiver operating char-acteristic curve (ROC) was used to analyze the diagnostic value of blood glucose, blood lipid, CysC and Hcy for coronary heart disease. Results: Multivariate binary logistic regression analysis showed that blood glucose (OR = 1.257), triglyceride (OR = 1.724), total cholesterol (OR = 1.458), low-density lipoprotein (OR = 3.776), LP(a) (OR = 1.038), Cystatin C (OR = 6.942), nonestesterified fatty acid (OR = 1.002) and homocysteine (OR = 1.304) were independent risk factors for coronary heart disease, the corresponding sensitivities of which were 0.63, 0.481, 0.776, 0.578, 0.401, 0.438, 0.414 and 0.889, and the specificities were 0.619, 0.81, 0.583, 0.692, 0.875, 0.794, 0.954 and 0.637. The sensitivity and specificity of the combined predictors were 0.868 and 0.85. And high-density lipoprotein (OR = 0.164) was negatively correlated with coronary heart disease. Conclusion: The combination detection of blood glucose, blood lipid, CysC and Hcy has important significance in pre-dicting coronary heart disease, which can be widely used in clinic.