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目的探讨传统心血管病危险因子、颈动脉硬化及其积分对冠脉病变的预测价值。方法回顾分析因胸痛拟诊冠心病入院的309例女性患者的年龄、高血压、血脂异常、糖尿病、颈动脉彩超结果和冠脉造影检查结果的关系;通过计算ROC曲线下面积,评价危险因素和颈动脉硬化及积分对冠脉病变的预测价值。结果对女性胸痛患者罹患冠心病的预测,老年、高血压、血脂异常、糖尿病ROC曲线下面积分别为0.623,0.574,0.580,0.590;引入颈动脉硬化/颈动脉硬化积分后,ROC曲线下面积分别为0.697/0.727,0.683/0.725,0.674/0.718,0.692/0.730。对女性冠心病患者多支病变的预测,老年、高血压、血脂异常、糖尿病ROC曲线下面积分别为0.597,0.524,0.508,0.547;引入颈动脉硬化/颈动脉硬化积分后,ROC曲线下面积分别为0.678/0.730,0.636/0.716,0.615/0.698,0.646/0.718。传统危险因素对女性胸痛患者罹患冠心病的预测或对女性冠心病患者多支病变的预测时,引入颈动脉硬化或颈动脉硬化积分前后ROC曲线下面积比较,P<0.01。引入颈动脉硬化积分与颈动脉硬化后ROC曲线下面积比较,P<0.05。结论颈动脉硬化积分和颈动脉硬化对预测冠心病及病变范围有帮助,并能在传统危险因素的基础上增加对冠心病的预测价值,而颈动脉硬化积分较颈动脉硬化更佳。
Objective To investigate the predictive value of traditional cardiovascular risk factors, carotid atherosclerosis and its integral on coronary artery disease. Methods The relationship between age, hypertension, dyslipidemia, diabetes mellitus, carotid ultrasonography and coronary angiography was retrospectively analyzed in 309 female patients admitted with CHD due to chest pain. By calculating the area under the ROC curve, the risk factors and Predictive value of carotid atherosclerosis and integral on coronary lesions. Results The prediction of coronary heart disease in women with chest pain was 0.623,0.574,0.580 and 0.590, respectively. The area under the ROC curve of carotid atherosclerosis / carotid atherosclerosis were separately calculated by area under the curve of ROC, age, hypertension, dyslipidemia and diabetes mellitus 0.697 / 0.727, 0.683 / 0.725, 0.674 / 0.718, 0.692 / 0.730. The area under the ROC curve of elderly patients with hypertension, dyslipidemia and diabetes mellitus were 0.597,0.524,0.508,0.547, respectively. The area under the curve of ROC after the introduction of carotid atherosclerosis / carotid atherosclerosis score 0.678 / 0.730, 0.636 / 0.716, 0.615 / 0.698, 0.646 / 0.718. Traditional risk factors for the prediction of coronary heart disease in women with chest pain or prediction of multi-vessel disease in women with coronary artery disease, the area under the ROC curve before and after the introduction of carotid atherosclerosis or carotid atherosclerosis score, P <0.01. The carotid atherosclerosis score and carotid atherosclerosis area under the ROC curve were compared, P <0.05. Conclusion Carotid arteriosclerosis score and carotid atherosclerosis are helpful in predicting coronary heart disease and disease range, and can increase the predictive value of coronary heart disease on the basis of traditional risk factors, while carotid arteriosclerosis score is better than carotid atherosclerosis.