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血清C反应蛋白/白蛋白及同型半胱氨酸/高密度脂蛋白胆固醇在冠状动脉微血管性心绞痛中的诊断价值

The diagnostic value of serum C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol in coronary microvascular angina pectoris.

作者信息

Zhao Wenxin, Zhao Xianfeng, Li Zhongyan

机构信息

Dalian Medical University, The Second Affiliated Hospital, Department of Cardiology - Dalian, China.

Fuwai Central China Cardiovascular Hospital, Department of Cardiology - Zhengzhou, China.

出版信息

Rev Assoc Med Bras (1992). 2025 Jun 16;71(5):e20241772. doi: 10.1590/1806-9282.20241772. eCollection 2025.

Abstract

OBJECTIVE

The aim of this study was to investigate the correlation between the serum C-reactive protein/albumin ratio and homocysteine/high-density lipoprotein-cholesterol ratio with microvascular angina and assess their predictive value.

METHODS

A total of 70 patients diagnosed with microvascular angina comprised the observation group, while 68 patients with normal or minimal (<50%) coronary stenosis and normal coronary blood flow formed the control group. Serum C-reactive protein, albumin, homocysteine, high-density lipoprotein-cholesterol, and other indexes were measured, and C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol ratios were calculated. Logistic regression, Pearson's correlation, and receiver operating characteristic analyses were conducted to identify independent risk factors for microvascular angina.

RESULTS

Significant differences in C-reactive protein, C-reactive protein/albumin, homocysteine, and homocysteine/high-density lipoprotein-cholesterol levels were found between the microvascular angina and control groups (p<0.05). Multivariate logistic regression analysis showed that C-reactive protein, C-reactive protein/albumin, homocysteine, and homocysteine/high-density lipoprotein-cholesterol were independent risk factors for microvascular angina, with the risk increasing alongside elevated C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol levels. The receiver operating characteristic analysis demonstrated that C-reactive protein/albumin, homocysteine/high-density lipoprotein-cholesterol, and their combined use were predictive of microvascular angina, with the combined area under the curve value exceeding that of individual markers.

CONCLUSIONS

Elevated C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol offer predictive value for microvascular angina diagnosis, with the combination providing superior diagnostic accuracy over individual indicators, supporting early microvascular angina identification.

摘要

目的

本研究旨在探讨血清C反应蛋白/白蛋白比值和同型半胱氨酸/高密度脂蛋白胆固醇比值与微血管性心绞痛之间的相关性,并评估它们的预测价值。

方法

总共70例被诊断为微血管性心绞痛的患者组成观察组,而68例冠状动脉狭窄正常或轻微(<50%)且冠状动脉血流正常的患者组成对照组。检测血清C反应蛋白、白蛋白、同型半胱氨酸、高密度脂蛋白胆固醇及其他指标,并计算C反应蛋白/白蛋白和同型半胱氨酸/高密度脂蛋白胆固醇比值。进行逻辑回归、Pearson相关性分析和受试者工作特征分析,以确定微血管性心绞痛的独立危险因素。

结果

微血管性心绞痛组和对照组在C反应蛋白、C反应蛋白/白蛋白、同型半胱氨酸和同型半胱氨酸/高密度脂蛋白胆固醇水平上存在显著差异(p<0.05)。多因素逻辑回归分析表明,C反应蛋白、C反应蛋白/白蛋白、同型半胱氨酸和同型半胱氨酸/高密度脂蛋白胆固醇是微血管性心绞痛的独立危险因素,随着C反应蛋白/白蛋白和同型半胱氨酸/高密度脂蛋白胆固醇水平升高,风险增加。受试者工作特征分析表明,C反应蛋白/白蛋白、同型半胱氨酸/高密度脂蛋白胆固醇及其联合使用可预测微血管性心绞痛,联合曲线下面积值超过单个标志物。

结论

升高的C反应蛋白/白蛋白和同型半胱氨酸/高密度脂蛋白胆固醇对微血管性心绞痛诊断具有预测价值,联合使用比单个指标具有更高的诊断准确性,有助于早期识别微血管性心绞痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d12c/12172528/223e6ec9bc91/1806-9282-ramb-71-05-e20241772-gf01.jpg

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