血清低密度脂蛋白胆固醇、超敏C反应蛋白联合颈动脉超声参数诊断疑似冠心病患者的价值

doi:10.3969/j.issn.1006-5725.2025.09.019

Abstract

Abstract:

Objective To investigate the predictive value of serum low-density lipoprotein cholesterol（LDL-C） and high-sensitive C-reactive protein（hs-CRP） in combination with carotid ultrasound parameters for assessing the risk of coronary heart disease（CHD）in patients with suspected cases. Methods A total of 260 patients who underwent coronary angiography（CAG） in the Department of Cardiology at Wujin Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from August 2022 to August 2024 due to suspected CHD were enrolled in this study. Based on CAG results， patients were categorized into a non-CHD group（n = 110） and a CHD group（n = 150）. General clinical characteristics， serum LDL-C， hs-CRP levels， and carotid ultrasound arameters-including carotid intima-media thickness （CIMT） and Crouse score of carotid artery plaque-were compared between the two groups. Spearman correlation analysis and multivariate logistic regression analysis were conducted to evaluate the associations among these parameters. The predictive value of individual and combined markers for suspected CHD was assessed by using receiver operating characteristic（ROC） curve analysis. Results （1）The coronary heart disease（CHD） group had higher age， smoking，fasting plasma glucose（FPG）， and blood pressure compared to the non-CHD group（P > 0.05）. No significant difference was observed in the gender ratio， alcohol consumption rates， and body mass index（BMI）， between the two groups（P > 0.05）. （2） Total cholesterol（TC）， LDL-C， hs-CRP levels， and carotid ultrasound parameters were significantly higher in the CHD group than those in the non-CHD group （P < 0.05）. （3） Spearman correlation analysis and multivariate logistic regression analysis revealed that serum LDL-C，hs-CRP，and carotid ultrasound parameters were significantly correlated with coronary heart disease（P < 0.05）. （4） ROC curve analysis demonstrated that the combined assessment of serum LDL-C， hs-CRP， and carotid ultrasound parameters achieved the highest area under the curve （AUC）， sensitivity， and specificity， with statistically significant differences compared to individual markers（P < 0.05）. Conclusions Serum LDL-C，hs-CRP，and carotid ultrasound parameters individually have predictive value for coronary heart disease， while their combined assessment offers superior predictive accuracy. The enhanced diagnostic performance of the combined valuation provides valuable guidance for the diagnosis and management of patients with suspected coronary heart disease.

Key words: coronary heart disease, low-density lipoprotein cholesterol, high sensitive C-reactive protein, carotid ultrasound, carotid intima-media thickness, Crouse score of carotid plaque

CLC Number:

R541.4

Chengyu QIAN,Linsheng WANG,Xingjiang XIONG,Weidong QIAN. Predictive value of serum LDL⁃C and hs⁃CRP combined with carotid ultrasound parameters in patients with suspected coronary heart disease[J]. The Journal of Practical Medicine, 2025, 41(9): 1401-1406.

Figures/Tables 6

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References 29

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项目	非冠心病组（n = 110）	冠心病组（n = 150）	t/χ²值	P值
年龄/岁	55.17 ± 8.64	66.01 ± 8.72	0.632	0.040
性别/［例（%）］
男	60（54.5）	83（55.3）	0.640	0.205
女	50（45.5）	67（44.7）	0.582	0.315
吸烟/［例（%）］	12（10.9）	29（19.3）	0.742	0.043
饮酒/［例（%）］	16（14.5）	26（17.3）	0.651	0.087
BMI/（kg/m²）	23.45 ± 2.18	27.76 ± 3.01	0.547	0.062
FPG/（mmol/L）	5.63 ± 0.35	7.32 ± 0.48	0.502	0.044
SBP/mmHg	136.3 ± 22.7	156.7 ± 21.1	0.492	0.045
DBP/mmHg	81.5 ± 20.6	99.3 ± 19.7	0.817	0.047
高血压/［例（%）］	17（15.5）	34（22.7）	0.672	0.039
糖尿病/［例（%）］	12（10.9）	32（21.3）	0.701	0.036

项目	非冠心病组（n = 150）	冠心病组（n = 210）	t值	P值
TC/（mmol/L）	4.06 ± 1.43	5.91 ± 1.51	8.456	0.047
TG/（mmol/L）	3.51 ± 1.08	3.60 ± 1.21	1.642	0.241
HDL-C/（mmol/L）	1.72 ± 0.21	1.69 ± 0.47	3.428	0.306
LDL-C/（mmol/L）	3.24 ± 1.61	4.98 ± 1.55	9.624	0.034
hs-CRP/（mg/L）	5.45 ± 2.68	9.23 ± 2.49	11.397	0.042
CIMT/mm	1.04 ± 0.38	3.62 ± 0.37	11.325	0.031
颈动脉斑块Crouse积分/mm	0.95 ± 0.21	3.93 ± 0.41	13.246	0.029

项目	与冠心病的相关性
项目	r值	P值
LDL-C	0.535	< 0.05
hs-CRP	0.589	< 0.05
CIMT	0.612	< 0.05
颈动脉斑块Crouse积分	0.674	< 0.05

变量	β	SE	Waldχ²	OR	95%CI	P值
TC	0.160	0.047	18.79	1.133	1.136 ~ 1.381	< 0.05
TG	-0.256	0.052	0.029	0.968	0.901 ~ 1.214	> 0.05
HDL-C	0.004	0.126	0.021	1.261	0.894 ~ 1.326	> 0.05
LDL-C	0.329	0.042	30.75	1.383	1.247 ~ 1.587	< 0.05
hs-CRP	0.275	0.049	25.33	1.239	1.126 ~ 1.346	< 0.05
CIMT	0.283	0.041	31.24	1.362	1.119 ~ 1.419	< 0.05
颈动脉斑块Crouse积分	0.361	0.037	35.72	1.640	1.074 ~ 1.301	< 0.05

指标	灵敏度/%	特异度/%	AUC	95%CI	截断值	Youden指数
LDL-C	70.34	69.08	0.683^*	0.680 ~ 0.724	5.43	0.504
hs-CRP	73.01	65.06	0.715^*	0.673 ~ 0.865	9.34	0.561
CIMT	74.45	73.39	0.692^*	0.701 ~ 0.848	1.22	0.538
颈动脉斑块Crouse积分	78.19	77.63	0.701^*	0.813 ~ 0.872	2.48	0.718
联合预测	82.71	81.24	0.845	0.912 ~ 1.000	-	0.891

Predictive value of serum LDL⁃C and hs⁃CRP combined with carotid ultrasound parameters in patients with suspected coronary heart disease

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