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脂蛋白a、纤维蛋白原及C反应蛋白在冠心病早期诊断中的应用

许宏洲 陶言言 陆国玉 吴晓飞

许宏洲, 陶言言, 陆国玉, 吴晓飞. 脂蛋白a、纤维蛋白原及C反应蛋白在冠心病早期诊断中的应用[J]. 中华全科医学, 2024, 22(4): 548-550. doi: 10.16766/j.cnki.issn.1674-4152.003446
引用本文: 许宏洲, 陶言言, 陆国玉, 吴晓飞. 脂蛋白a、纤维蛋白原及C反应蛋白在冠心病早期诊断中的应用[J]. 中华全科医学, 2024, 22(4): 548-550. doi: 10.16766/j.cnki.issn.1674-4152.003446
XU Hongzhou, TAO Yanyan, LU Guoyu, WU Xiaofei. Application of lipoprotein a, fibrinogen and C-reactive protein in early diagnosis of coronary heart disease[J]. Chinese Journal of General Practice, 2024, 22(4): 548-550. doi: 10.16766/j.cnki.issn.1674-4152.003446
Citation: XU Hongzhou, TAO Yanyan, LU Guoyu, WU Xiaofei. Application of lipoprotein a, fibrinogen and C-reactive protein in early diagnosis of coronary heart disease[J]. Chinese Journal of General Practice, 2024, 22(4): 548-550. doi: 10.16766/j.cnki.issn.1674-4152.003446

脂蛋白a、纤维蛋白原及C反应蛋白在冠心病早期诊断中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003446
基金项目: 

安徽省教育厅高校科学研究重大项目 KJ2021ZD0083

蚌埠医学院自然科学重点项目 2021byzd157

详细信息
    通讯作者:

    吴晓飞,E-mail:13805529866@163.com

  • 中图分类号: R541.4 R446.112

Application of lipoprotein a, fibrinogen and C-reactive protein in early diagnosis of coronary heart disease

  • 摘要:   目的  探讨分析血清脂蛋白a(Lpa)、血浆纤维蛋白原(FIB)和C反应蛋白(CRP)三者检测指标在冠心病(CHD)诊断中的意义。  方法  选取2020年3月—2021年5月在蚌埠医科大学第一附属医院就诊的43例CHD患者作为CHD组,选择同一时段在该院就诊行冠状动脉造影结果正常的45例健康志愿者作为对照组,比较2组临床资料。分别应用免疫比浊法、凝固法和免疫透射比浊方法检测CHD组及对照组研究对象血浆中的Lpa、FIB与CRP水平并进行比较。通过ROC曲线分析各指标单独诊断及三者联合诊断CHD的诊断价值及最佳阈值。  结果  CHD组Lpa、FIB与CRP水平均高于对照组(P < 0.05)。血清Lpa、FIB、CRP单独检测诊断CHD的AUC分别为0.771(95% CI:0.674~0.868)、0.749(95% CI: 0.640~0.859)、0.791(95% CI: 0.697~0.886),灵敏度分别为53.13%、50.00%、59.38%,特异度分别为81.08%、78.39%、78.29%;三者联合检测诊断CHD的AUC为0.884(95% CI: 0.813~0.956),灵敏度为81.25%,特异度为78.29%,血清Lpa、FIB、CRP三者联合检测诊断CHD优于单独检测。  结论  Lpa、FIB与CRP联合检测可提高CHD诊断的灵敏度,有利于CHD患者的早期发现,从而采取积极有效措施以干预CHD疾病的发展。

     

  • 图  1  Lpa、FIB与CRP单独及三者联合诊断CHD的ROC曲线

    Figure  1.  ROC curve analysis of Lpa, FIB and CRP alone and combination for the diagnosis of CHD

    表  1  CHD组与对照组一般资料比较

    Table  1.   Comparison of general information between CHD group and control group

    组别 例数 年龄(x±s, 岁) 性别[例(%)]
    男性 女性
    CHD组 43 60.51±3.38 24(55.81) 19(44.19)
    对照组 45 59.47±4.76 24(53.33) 21(46.67)
    统计量 1.186a 0.055b
    P 0.236 0.815
    注:at值,b为χ2值。
    下载: 导出CSV

    表  2  CHD组与对照组Lpa、FIB及CRP水平比较(x±s)

    Table  2.   Comparison of Lpa, FIB, and CRP between CHD group and control group(x±s)

    组别 例数 Lpa(mg/L) FIB(g/L) CRP(mg/L)
    CHD组 43 328.41±40.67 3.54±0.69 12.69±3.50
    对照组 45 253.31±59.16 2.82±0.47 7.93±2.98
    t 6.965 5.695 6.878
    P <0.001 <0.001 <0.001
    下载: 导出CSV

    表  3  Lpa、FIB与CRP单独及三者联合诊断CHD的效能分析

    Table  3.   Efficacy analysis of Lpa, FIB and CRP alone and combination for the diagnosis of CHD

    项目 AUC 95% CI 灵敏度(%) 特异度(%) 准确度(%) 阳性预测值(%) 阴性预测值(%) 约登指数
    Lpa 0.771a 0.674~0.868 53.13 81.08 68.12 70.83 66.67 0.342
    FIB 0.749a 0.640~0.859 50.00 78.39 65.22 66.67 64.44 0.284
    CRP 0.791a 0.697~0.886 59.38 78.29 76.81 86.36 72.34 0.377
    联合诊断 0.884 0.813~0.956 81.25 78.29 79.72 76.48 87.89 0.595
    注:与联合诊断比较,aP<0.05。
    下载: 导出CSV
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  • 收稿日期:  2023-11-08
  • 网络出版日期:  2024-05-29

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