甘油三酯葡萄糖指数与老年AMI患者冠状动脉病变程度的研究

Triglyceride Glucose Index in the Severity of Coronary Artery Disease in Elderly Patients with AMI

摘要: 目的：探究甘油三酯葡萄糖指数(triglyceride-glucose index, TyG)与老年急性心肌梗死(acute myo-cardial infarction, AMI)患者冠状动脉病变程度的关系。方法：回顾性分析2018-1至2021-9就诊于青岛大学附属医院冠状动脉造影术(coronary angiography, CAG)诊断为急性心肌梗死的老年患者(年龄 > 65岁)，共纳入248例。根据Gensini评分，将入组患者分轻中度病变组(GS ≤ 50，117例)，重度病变组(GS > 50，131例)，根据造影病变支数的不同，分为单支病变组63例、双支病变组103例和多支病变组82例。比较各组TyG的差异，并分析TyG与老年AMI患者冠状动脉病变严重程度的关系。结果：老年AMI患者重度病变组TyG水平明显高于轻中度病变组，多支病变组TyG指数明显高于双支病变组和单支病变组，差异有统计学意义(P < 0.05)。将Gensini评分与TyG指数进行Spearman相关分析显示，Gensini评分与TyG指数水平呈正相关(r = 0.319, P < 0.001)，二元Logistic回归分析结果显示：TyG指数为老年AMI患者冠脉重度病变的独立危险因素(OR 3.009, 95% CI 1.613~5.612, P < 0.001)，TyG预测老年AMI患者冠脉重度病变的ROC (接受者操作特征)曲线下面积为0.664 (95% CI 0.596~0.731, P < 0.001)，最佳诊断分界点为8.47，敏感度为82%，特异度为45%。结论：TyG指数水平可作为评估老年AMI患者冠状动脉病变程度的指标。

Abstract: Objective: To investigate the relationship between triglyceride glucose index (TyG) and the severity of coronary artery disease in elderly patients with acute myocardial infarction (AMI). Methods: A total of 248 elderly patients (age > 65 years) diagnosed with acute myocardial infarction by coro-nary angiography (CAG) in the Affiliated Hospital of Qingdao University from January 2018 to Sep-tember 2021 were retrospectively analyzed. According to Gensini score, the enrolled patients were divided into mild to moderate disease group (GS ≤ 50, 117 cases) and severe disease group (GS > 50, 131 cases). According to the number of angiographic lesions, the patients were divided into sin-gle-vessel disease group (n = 63), double-vessel disease group (n = 103) and multi-vessel disease group (n = 82). The differences of TyG in each group were compared, and the relationship between TyG and the severity of coronary artery disease in elderly AMI patients was analyzed. Results: The level of TyG in elderly patients with AMI was significantly higher than that in patients with mild AMI. The TyG index in patients with multivessel disease was significantly higher than that in pa-tients with double-vessel disease and single-vessel disease (P < 0.05). Spearman correlation analy-sis between Gensini score and TyG index showed that Gensini score was positively correlated with TyG index level (r = 0.319, P < 0.001). Binary Logistic regression analysis showed that TyG index was an independent risk factor for severe coronary artery disease in elderly patients with AMI (OR 3.009, 95% CI 1.613~5.612, P < 0.001). The ROC (receiver operating characteristic) curve of TyG in predicting severe coronary artery disease in elderly patients with AMI was 0.664 (95% CI 0.596~0.731, P < 0.001), the optimal diagnostic cut-off point was 8.47, the sensitivity was 82%, and the specificity was 45%. Conclusion: TyG index can be used as an index to evaluate the severity of coronary artery disease in elderly patients with AMI.