脂蛋白胆固醇用于冠心病筛检试验的评价

至今尚无适于人群筛检冠心病的理想方法。38例心电图踏车运动试验阳性的病例组,与同期试验阴性的71例对照组进行筛检试验评价研究。选择TC/HDL-C、HDL-C/TC、LDL-C/HDL-C、HDL₂-C/HDL₃-C等比值为筛检指标,评价其不同界限值的真实性、预测值等。TC/HDL-C与HDL₂-C/HDL₃-C并联使用可以提高检出率达92%。多元逐步回归分析只有TC/HDL-C选入方程,计算其5个组段的阳性似然比,并以不同的验前概率拟代,结果验后概率以TC/HDL-C≥3.2最大,因此,国内"动脉粥样硬化指标"TC/HDL-C的界限值可定为≥3.2。

The Evaluation of Lipoprotein as a Screening Test for Coronary Heart Disease

Up to now there is no screening test suitable for coronary heart disease (CHD) among population. 38 cases of CHD diagnosed by electrocardiographic bicycle exercise and 71 cases with negative results as controls were studied concurrently to evaluate the screening test of CHD. According to the significant difference between the two groups, the ratio of TC/HDL-C.HDL-C/TC.LDL-C/HDL-C.HDL2-C/HDL3-C were selected to evaluate their validity and predictivity etc, on several cutoff vale respectively. TC/HDL-C and HDL2-C/HDL3-C were used in parallel to promote the detective value of CHD to 92%. TC/HDL-C was only selected in stepwise regression formula, so the positive likelihood of five-grade value of TC/HDL-C was calculated and different prior-test probability was estimated to predict the post-test probability of CHD. As a result cutoff value 3.2 of TC/HDL-C could be determined as atherogenic index in chinese population.