Kambara H, Imoto A, Owada C, Tamaki S, Fudo T, Maetani S
College of Medical Technology, Kyoto University, Japan.
Jpn Circ J. 1992 Dec;56(12):1199-205. doi: 10.1253/jcj.56.1199.
Risk factor analysis in coronary artery disease was conducted in 303 patients who underwent coronary arteriography to identify associations between personal characteristics and the prevalence of coronary heart disease. Age, sex, obesity, smoking, alcohol intake, hypertension, diabetes mellitus, serum uric acid, total cholesterol, LDL- and HDL-cholesterol, triglyceride, and atherogenic indices were statistically analyzed. All 13 variables were first compared between patients with positive and negative ergonovine tests. Only total cholesterol was significantly different, while significant differences in age, sex, history of diabetes, total cholesterol, LDL- and HDL-cholesterol, triglyceride and atherosclerotic indices were observed between patients with and without organic coronary artery stenosis. A multivariate analysis was performed, and the resulting equation was tested using the remaining patients. Logistic analysis of all 13 variables identified 5 (age, sex, diabetes mellitus, LDL- and HDL-cholesterol) which accounted for the differences between patients with and without significant coronary artery disease and that were validated in the test group. The sensitivity for prediction of coronary artery disease was 75.8%, specificity 68.5%, and predictive accuracy 71.5% in the test group. Thus, risk factor analysis appears to be very valuable in screening subjects with high-risk organic coronary stenosis and in optimizing the preventive and therapeutic modalities, but not in predicting vasospastic subjects.
对303例行冠状动脉造影的患者进行了冠状动脉疾病的危险因素分析，以确定个人特征与冠心病患病率之间的关联。对年龄、性别、肥胖、吸烟、饮酒、高血压、糖尿病、血清尿酸、总胆固醇、低密度脂蛋白和高密度脂蛋白胆固醇、甘油三酯以及致动脉粥样硬化指数进行了统计分析。首先比较了麦角新碱试验阳性和阴性患者的所有13个变量。只有总胆固醇有显著差异，而有和无器质性冠状动脉狭窄的患者在年龄、性别、糖尿病史、总胆固醇、低密度脂蛋白和高密度脂蛋白胆固醇、甘油三酯及动脉粥样硬化指数方面存在显著差异。进行了多变量分析，并使用其余患者对所得方程进行了检验。对所有13个变量进行逻辑分析，确定了5个变量（年龄、性别、糖尿病、低密度脂蛋白和高密度脂蛋白胆固醇），这些变量解释了有和无显著冠状动脉疾病患者之间的差异，并在测试组中得到了验证。测试组中预测冠状动脉疾病的敏感性为75.8%，特异性为68.5%，预测准确性为71.5%。因此，危险因素分析在筛查高危器质性冠状动脉狭窄患者以及优化预防和治疗方式方面似乎非常有价值，但在预测血管痉挛性患者方面则不然。
