皮肤胆固醇测定联合心电图平板运动对不典型胸痛患者冠心病诊断分析

doi:10.3969/j.issn.1006-5725.2023.20.020

Abstract

Abstract:

Objective To explore the clinical predictive value of skin cholesterol and electrocardiogram treadmill exercise （EET） for coronary heart disease （CHD） in patients with atypical chest pain. Methods One hundred and twenty-eight patients with atypical chest pain admitted from April 2020 to April 2021 were enrolled. All patients did not take any lipid-lowering drugs or anti-myocardial ischemia drugs within 1 month before admission. Skin cholesterol content test， EET test， coronary angiography， Gensini score and number of diseased vessels were completed during hospitalization. According to the results of coronary angiography， the patients were divided into CHD group and non-CHD group. General clinical data， skin cholesterol content and EET results of the two groups were analyzed. Correlation analysis was performed between skin cholesterol content and Gensini score. Multivariate logistic regression was used to screen factors with predictive value for the diagnosis of CHD in patients with atypical chest pain. Results The content of cholesterol in skin increased significantly in patients with CHD. With the increase of the number of coronary artery lesions， the content of cholesterol in skin also increased significantly. Skin cholesterol content was positively correlated with Gensini score. Logistic regression analysis showed that skin cholesterol content and EET positive were predictors of CHD. The area under ROC curve of skin cholesterol content and EET in predicting the diagnosis of CHD in patients with atypical chest pain was 0.879 and 0.617， the corresponding sensitivity 86.2% and 67.3%， and the specificity 74.3% and 49.3%， respectively. The area under ROC curve of the combination of the two in predicting the diagnosis of CHD in patients with atypical chest pain was 0.917， and the sensitivity and specificity were 91.5% and 82.3%， respectively. Conclusion Skin cholesterol content is of good value in the diagnosis of CHD in patients with atypical chest pain， and EET can further improve the sensitivity and specificity of diagnosis.

Key words: skin cholesterol, coronary heart disease, area under curve

CLC Number:

R446.19

Kun DU,Wentao CHEN,Xiaoling JU,Jie. WANG. Analysis of skin cholesterol determination combined with ECG treadmill exercise in diagnosis of coronary heart disease in patients with atypical chest pain[J]. The Journal of Practical Medicine, 2023, 39(20): 2671-2675.

Figures/Tables 6

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References 16

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变量	冠心病组（n = 55）	非冠心病组（n = 73）	t/χ²值	P值
男性［例（%）］	31（56.36）	32（43.84）	1.969 7	0.160 5
年龄（岁）	58.28 ± 8.65	56.14 ± 9.93	1.274 7	0.204 8
BMI（kg/m²）	25.18 ± 3.32	24.12 ± 3.65	1.690 2	0.093 5
SBP（mmHg）	136.02 ± 9.37	131.41 ± 11.18	1.399 8	0.164 0
DBP（mmHg）	84.58 ± 10.56	82.66 ± 10.18	1.039 5	0.300 6
FPG（mmol/L）	5.29 ± 2.31^*	4.91 ± 2.07	2.134 2	0.034 8
HbA_1C（mmol/L）	5.92 ± 0.76^*	5.66 ± 0.37	3.532 5	0.000 6
HDL（mmol/L）	1.20 ± 0.49	1.19 ± 0.27	0.147 3	0.883 1
LDL（mmol/L）	2.78 ± 1.09	2.69 ± 0.45	0.637 6	0.524 9
TC（mmol/L）	5.02 ± 1.06	4.82 ± 1.10	1.034 2	0.303 0
TG（mmol/L）	1.52 ± 0.67	1.48 ± 0.59	0.358 1	0.720 8
AST（U/L）	42.28 ± 3.67	40.94 ± 4.81	1.722 0	0.087 5
Cr（μmol/L）	70.27 ± 12.03	68.67 ± 8.93	0.863 9	0.389 3
皮肤胆固醇水平	0.35 ± 0.04^*	0.26 ± 0.06	9.624 5	< 0.001
心电图平板运动阳性［例（%）］	48（87.27）	7（9.59）	77.244 9	< 0.001

因素	β	SE	Wald χ²	P值	OR	95%CI
FPG	0.046	0.112	0.173	0.629	1.023	0.767 ~ 1.185
HbA_1C	0.867	0.513	2.288	0.106	2.546	0.687 ~ 7.573
皮肤胆固醇含量	-1.532	0.484	21.078	0.002	0.259	0.293 ~ 0.418
EET	0.632	0.236	6.142	0.008	1.763	1.028 ~ 2.743

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Analysis of skin cholesterol determination combined with ECG treadmill exercise in diagnosis of coronary heart disease in patients with atypical chest pain

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因素	AUC	95%CI	截断值	灵敏度（%）	特异度（%）
皮肤胆固醇水平	0.879	0.802 ~ 0.927	0.39	86.2	74.3
EET	0.617	0.811 ~ 0.926		67.3	49.3
皮肤胆固醇水平联合EET	0.917	0.886 ~ 0.974		91.5	82.3