血清学指标作为冠心病危险因素相关性分析及诊断价值的评价

目的通过对冠心病（CHD）患者血清中多项指标进行检测，分析各种指标对冠心病的诊断价值及其与冠心病严重程度的相关性。方法选取273例行冠状动脉造影的患者，按冠状动脉造影的结果分为CHD组和非CHD组。对11项血清学指标进行检测和统计学分析。利用多因素回归分析筛选出合适的血清学指标，分析其独立诊断价值及组合上述指标对冠心病的诊断价值。结果CHD组总胆固醇、低密度脂蛋白胆固醇、载脂蛋白Al、脂蛋白（a）和超敏C反应蛋白水平高于非CHD组，总胆红素和高密度脂蛋白胆固醇低于非CHD组，差异均有统计学意义（P〈0．05）。两组患者三酰甘油、直接胆红素、载脂蛋白B、肌钙蛋白等4项指标间差异无统计学意义（P〉0．05）。超敏C反应蛋白。脂蛋白（a）及胆红素等指标与冠心病严重程度具有较好的相关性（P〈0．05），多因素回归分析共筛选出4项指标，但单项指标的诊断价值均有限（AUROC〈0．75），4指标组合诊断价值优于任何单项指标（AUROC=0．845）。结论本研究对多项冠心病相关血清学指标进行评价，多数指标具有独立的诊断价值，但是单项血清学指标的诊断价值不高。而结合我们筛选的4项指标取得了较高的诊断价值。

The Evaluation of Diagnostic Value and Correlative Analysis of Serum Markers for Coronary Heart Disease ZHONG

Objective To evaluate the diagnosstie value and analyze the correlation of serum markers for coronary heart disease, serum samples from patients with CHD were detected. Methods A total of 273 serum samples from patients with coronary angiography were collected and 11 biochemical markers were detected, results were analysed by statistical method and multivariate regression analysis was performed to choose markers for coronary heart disease diagnosis. Results High - sensitivity C - reactive protein, Lipoprotein and bilirubin had good correlations with disease （ P 〈 0. 05 ） , 4 markers were picked out, however, single markers had limited diagnostic values （ AUROC 〈 0. 75 ）. Therefore, combination with 4 markers were developed and had better diagnostic value than single markers （ AUROC = 0. 845）. Conclusion Most of serum markers had independent diagnostic value but limited, 4 markers combination we developed had better values for coronary heart disease.