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目的分析血脂各指标对冠心病患者的临床应用价值。方法分别确定79例冠心病患者和70例非冠心病人员作为分析组及对照组,分别测定Lp(a)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及A1/B比值,应用ROC曲线及其它评价指标进行比较及分析。结果2组血脂检测结果比较,Lp(a)、TC、TG、HDL-C、ApoA1及A1/B差异有统计学意义(P<0.01/0.05);ROC曲线下面积(AUC)>0.7且差异有统计学意义(P<0.01)的有Lp(a)、HDL-C和ApoA1,分别为0.706、0.745及0.703;HDL-C的诊断灵敏度、阳性预测值、阴性预测值及阳性似然比最高,分别为43%、81%、58%及3.76,它的似然比最低,为0.64,诊断特异性最高是A1/B,最低是LDL-C。结论各项血脂指标对冠心病的诊断准确性较低,其中Lp(a)、HDL-C及ApoA1对CHD的临床应用价值较其它指标大。
Objective To analyze the clinical value of serum lipids in patients with coronary heart disease. Methods 79 patients with coronary heart disease and 70 patients with non-coronary heart disease were selected as the analysis group and control group respectively. The levels of Lp (a), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol C, LDL-C, ApoA1, ApoB and A1 / B ratio were compared and analyzed by ROC curve and other evaluation indexes. Results There was significant difference in Lp (a), TC, TG, HDL-C, ApoA1 and A1 / B between the two groups (P <0.01 / 0.05) The statistical significance (P <0.01) of Lp (a), HDL-C and ApoA1 were 0.706,0.745 and 0.703 respectively. The diagnostic sensitivity, positive predictive value, negative predictive value and positive likelihood ratio of HDL-C were the highest , Respectively, with 43%, 81%, 58% and 3.76, respectively, with the lowest likelihood ratio of 0.64. The highest diagnostic specificity was A1 / B and the lowest was LDL-C. Conclusion The diagnostic accuracy of various lipids in CHD is low. The clinical value of Lp (a), HDL-C and ApoA1 in CHD is higher than other indexes.