Tao Shi-Yi, Yu Lin-Tong, Wang Zi-Han, Chen Ying, Zhang Jin, Yang De-Shuang, Huang Li
Beijing University of Chinese Medicine Beijing 100029, China.
China-Japan Friendship Hospital Beijing 100029, China.
Zhongguo Zhong Yao Za Zhi. 2022 Apr;47(8):2244-2250. doi: 10.19540/j.cnki.cjcmm.20211201.501.
The present study explored the correlation of coronary heart disease(CHD) with blood stasis syndrome in postmenopausal women with artery elasticity and endothelial function indexes and evaluated the diagnostic efficacy of the prediction model via logistic regression and receiver operating characteristic(ROC) curve model. A retrospective comparison was made between 366 postmenopausal CHD patients from August 1, 2020, to September 30, 2021, in the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital, who were divided into the blood stasis syndrome group(n=196) and the non-blood stasis syndrome group(n=170). General clinical characteristics of the two groups were compared. Multivariate logistic regression analysis was used to probe the correlation of CHD with blood stasis syndrome in postmenopausal women with brachial-ankle pulse wave velocity(baPWV), ankle-brachial index(ABI), and flow-mediated dilatation(FMD), and the ROC curve was drawn to evaluate the diagnostic efficiency of the prediction model. Multivariate logistic regression analysis showed that the correlation coefficients of CHD with blood stasis syndrome in postmenopausal women with baPWV, ABI, and FMD were 1.123, 0.109, and 0.719, respectively(P=0.004, P=0.005, P<0.001),and the regression equation for predicting probability P was P=1/[1+e(-(3.131+0.116×baPWV-2.217×ABI-0.330×FMD))]. ROC curve analysis suggested that in the context of baPWV≥19.19 m·s(-1) or ABI≤1.22 or FMD≤9.7%, it was of great significance to predict the diagnosis of CHD with blood stasis syndrome in postmenopausal women. The AUC of baPWV, ABI, FMD, and prediction probability P was 0.763, 0.607, 0.705, and 0.836, respectively. The AUC of prediction probability P was higher than that of each index alone(P<0.001), and the sensitivity and specificity were 0.888 and 0.647, respectively. The results demonstrate that baPWV, ABI, and FMD are independently correlated with CHD with blood stasis syndrome in postmenopausal women, and show certain independent predictive abilities(P<0.05). The combined evaluation of the three possesses the best diagnostic efficiency.
本研究探讨绝经后女性冠心病(CHD)与血瘀证及动脉弹性和内皮功能指标的相关性,并通过逻辑回归和受试者工作特征(ROC)曲线模型评估预测模型的诊断效能。对2020年8月1日至2021年9月30日在中国-日本友好医院中西医结合心内科的366例绝经后冠心病患者进行回顾性比较,将其分为血瘀证组(n = 196)和非血瘀证组(n = 170)。比较两组的一般临床特征。采用多因素逻辑回归分析探讨绝经后女性冠心病与血瘀证、臂踝脉搏波速度(baPWV)、踝臂指数(ABI)和血流介导的血管舒张功能(FMD)的相关性,并绘制ROC曲线评估预测模型的诊断效率。多因素逻辑回归分析显示,绝经后女性冠心病与血瘀证、baPWV、ABI和FMD的相关系数分别为1.123、0.109和0.719(P = 0.004,P = 0.005,P < 0.001),预测概率P的回归方程为P = 1/[1 + e(-(3.131 + 0.116×baPWV - 2.217×ABI - 0.330×FMD))]。ROC曲线分析表明,在baPWV≥19.19 m·s(-1)或ABI≤1.22或FMD≤9.7%的情况下,预测绝经后女性冠心病血瘀证的诊断具有重要意义。baPWV、ABI、FMD和预测概率P的AUC分别为0.763、0.607、0.705和0.836。预测概率P的AUC高于各单项指标(P < 0.001),灵敏度和特异度分别为0.888和0.647。结果表明,baPWV、ABI和FMD与绝经后女性冠心病血瘀证独立相关,并具有一定的独立预测能力(P < 0.05)。三者联合评估具有最佳的诊断效率。