血管钙化的影响因素及预测指标

doi:10.3969/j.issn.1004-583X.2022.02.003

摘要/Abstract

摘要：

目的分析血管钙化的预测因素,探究血管钙化的有效预测指标。方法回顾性分析河北医科大学第一医院血管外科2018年8月至2020年7月收治的患者467例,依据有无血管钙化分为病例组及对照组,并收集其临床资料。通过单因素及多因素Logistic回归分析血管钙化的影响因素,绘制受试者工作特征(receiver operating characteristic, ROC)曲线分析预测价值。结果 467例中有血管钙化191例(40.9%),白蛋白/纤维蛋白原比值(OR值为0.725,95%CI 0.630~0.834,P<0.01)、纤维蛋白原降解产物(OR值为1.626,95%CI 1.086~2.433,P=0.018)、脂蛋白(OR值为1.003,95%CI 1.002~1.004,P<0.01)、高密度脂蛋白胆固醇(OR值为0.101,95%CI 0.016~0.630,P=0.014)、总胆固醇(OR值为4.009,95%CI 1.619~9.926,P<0.01)、低密度脂蛋白胆固醇(OR值为0.148,95%CI 0.042~0.517,P<0.01)为血管钙化的独立预测因素,其曲线下面积(area under the curve, AUC)分别为0.828、0.780、0.720、0.679、0.570、0.563。结论白蛋白/纤维蛋白原比值、纤维蛋白原降解产物、脂蛋白、高密度脂蛋白胆固醇、总胆固醇、低密度脂蛋白胆固醇为血管钙化的独立预测因素。白蛋白/纤维蛋白原比值、纤维蛋白原降解产物、脂蛋白有较好的预测血管钙化的能力,其中白蛋白/纤维蛋白原比值预测血管钙化的价值最高。

关键词: 血管钙化, 白蛋白/纤维蛋白原比值, 危险因素, ROC曲线

Abstract:

Objective To analyze the predictive factors of vascular calcification, and to explore its effective prediction indicators.Methods A retrospective analysis was performed in totally 467 vascular calcification patients admitted to the Department of Vascular Surgery, the First Hospital of Hebei Medical University from August 2018 to July 2020. Those patients were registered into case group and control group as whether with or without vascular calcification, and the clinical data were collected. Univariate and multivariate Logistic regression analysis were used to explore influencing factors of vascular calcification. Receiver operating characteristic (ROC) curve was drawn to analyze predictive value.Results In 467 cases, there were 191 cases (40.9%, 191/467) with vascular calcification. The independent factors for predicting vascular calcification were albumin/fibrinogen ratio(OR=0.725, 95%CI 0.630-0.834, P<0.01), fibrinogen degradation product (OR=1.626, 95%CI 1.086-2.433, P=0.018), lipoprotein (OR=1.003, 95%CI 1.002-1.004, P<0.01), high density lipoprotein-cholesterol (OR=0.101, 95%CI 0.016-0.630, P=0.014), total cholesterol (OR=4.009, 95%CI 1.619-9.926, P<0.01), low density lipoprotein-cholesterol (OR=0.148, 95%CI 0.042-0.517, P<0.01), and the area under the curve (AUC) related the above parameters were 0.828, 0.780, 0.720, 0.679, 0.570, and 0.563, respectively.Conclusion The independent predictors for vascular calcification were albumin/fibrinogen ratio, fibrinogen degradation product, lipoprotein, high density lipoprotein-cholesterol, total cholesterol, low density lipoprotein-cholesterol, of which, albumin/fibrinogen ratio, fibrinogen degradation product and lipoprotein is better capable of predicting vascular calcification, and albumin/fibrinogen ratio has top advantageous value.

Key words: vascular calcification, albumin/fibrinogen ratio, risk factors, ROC curve

中图分类号:

R561.2

郑丽华, 杜润森, 赵亚恒, 刘鹏. 血管钙化的影响因素及预测指标[J]. 临床荟萃, 2022, 37(2): 114-118.

Zheng Lihua, Du Runsen, Zhao Yaheng, Liu Peng. Influencing factors and predictive indicators of vascular calcification[J]. Clinical Focus, 2022, 37(2): 114-118.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.02.003

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I2/114

图/表 4

参考文献 27

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项目	对照组(n=276)	病例组(n=191)	统计值	P值
性别(例)
男女	169 107	127 64	χ²=1.346	0.246
年龄(岁)	65.884±11.540	68.377±9.693	t=1.172	0.241
身高(cm)	169.673±28.235	167.037±14.870	t=0.117	0.459
体重(kg)	74.223±11.818	67.862±10.535	t=0.568	0.136
中性粒细胞占比(%)	0.604±0.087	0.679±0.108	t=0.763	<0.01
淋巴细胞占比(%)	0.303±0.080	0.226±0.094	t=0.877	<0.01
纤维蛋白原(g/L)	2.881±0.908	3.748±1.005	t=0.906	<0.01
FDP(mg/L)	0.780±1.008	6.215±35.884	t=0.214	<0.01
甘油三酯(mmol/L)	1.530±1.165	1.504±1.299	t=0.021	0.439
HDL-C(mmol/L)	1.123±0.329	0.968±0.243	t=0.536	<0.01
LDL-C(mmol/L)	2.856±0.683	2.705±0.758	t=0.211	<0.05
脂蛋白(mg/L)	205.057±243.927	391.962±301.786	t=0.681	<0.01
GGT(U/L)	26.663±21.357	34.395±41.667	t=0.234	<0.01
hs-CRP(mg/L)	2.221±4.752	26.826±54.662	t=0.634	<0.01
白蛋白(g/L)	41.364±3.609	36.864±5.376	t=0.983	<0.01
AFR	14.979±3.020	10.682±3.528	t=1.308	<0.01
总胆固醇(mmol/L)	4.586±0.930	4.355±1.116	t=0.224	<0.05

项目	对照组(n=276)	病例组(n=191)	统计值	P值
性别(例)
男女	169 107	127 64	χ²=1.346	0.246
年龄(岁)	65.884±11.540	68.377±9.693	t=1.172	0.241
身高(cm)	169.673±28.235	167.037±14.870	t=0.117	0.459
体重(kg)	74.223±11.818	67.862±10.535	t=0.568	0.136
中性粒细胞占比(%)	0.604±0.087	0.679±0.108	t=0.763	<0.01
淋巴细胞占比(%)	0.303±0.080	0.226±0.094	t=0.877	<0.01
纤维蛋白原(g/L)	2.881±0.908	3.748±1.005	t=0.906	<0.01
FDP(mg/L)	0.780±1.008	6.215±35.884	t=0.214	<0.01
甘油三酯(mmol/L)	1.530±1.165	1.504±1.299	t=0.021	0.439
HDL-C(mmol/L)	1.123±0.329	0.968±0.243	t=0.536	<0.01
LDL-C(mmol/L)	2.856±0.683	2.705±0.758	t=0.211	<0.05
脂蛋白(mg/L)	205.057±243.927	391.962±301.786	t=0.681	<0.01
GGT(U/L)	26.663±21.357	34.395±41.667	t=0.234	<0.01
hs-CRP(mg/L)	2.221±4.752	26.826±54.662	t=0.634	<0.01
白蛋白(g/L)	41.364±3.609	36.864±5.376	t=0.983	<0.01
AFR	14.979±3.020	10.682±3.528	t=1.308	<0.01
总胆固醇(mmol/L)	4.586±0.930	4.355±1.116	t=0.224	<0.05

项目	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
项目	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
中性粒细胞占比	1.118	11.828	0.009	<0.01	3 187.985	356.281	28 525.934
淋巴细胞占比	-0.849	6.035	0.020	<0.01	0.000	0.000	0.000
纤维蛋白原	0.936	6.731	0.019	0.063	3.719	2.727	5.072
FDP	0.569	0.431	1.743	<0.01	2.379	1.846	3.065
总胆固醇	1.001	0.342	8.567	0.020	0.797	0.659	0.965
HDL-C	-1.932	0.971	3.960	<0.01	0.074	0.030	0.182
LDL-C	-1.609	0.546	8.684	0.030	0.741	0.566	0.971
脂蛋白	0.063	0.001	3 969	<0.01	1.003	1.002	1.004
GGT	0.203	0.012	286.179	0.018	1.010	1.002	1.018
hs-CRP	0.026	0.023	1.277	<0.01	1.170	1.109	1.234
AFR	-0.622	0.723	0.739	<0.01	0.654	0.600	0.711
白蛋白	0.782	2.134	0.134	0.132	0.779	0.736	0.825

项目	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
项目	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
中性粒细胞占比	1.118	11.828	0.009	<0.01	3 187.985	356.281	28 525.934
淋巴细胞占比	-0.849	6.035	0.020	<0.01	0.000	0.000	0.000
纤维蛋白原	0.936	6.731	0.019	0.063	3.719	2.727	5.072
FDP	0.569	0.431	1.743	<0.01	2.379	1.846	3.065
总胆固醇	1.001	0.342	8.567	0.020	0.797	0.659	0.965
HDL-C	-1.932	0.971	3.960	<0.01	0.074	0.030	0.182
LDL-C	-1.609	0.546	8.684	0.030	0.741	0.566	0.971
脂蛋白	0.063	0.001	3 969	<0.01	1.003	1.002	1.004
GGT	0.203	0.012	286.179	0.018	1.010	1.002	1.018
hs-CRP	0.026	0.023	1.277	<0.01	1.170	1.109	1.234
AFR	-0.622	0.723	0.739	<0.01	0.654	0.600	0.711
白蛋白	0.782	2.134	0.134	0.132	0.779	0.736	0.825

项目	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
项目	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
中性粒细胞占比	1.228	6.243	0.039	0.844	3.413	0.000	703 933.786
淋巴细胞占比	-0.549	6.943	0.007	0.937	0.577	0.000	469 265.822
FDP	0.486	0.206	5.565	0.018	1.626	1.086	2.433
总胆固醇	1.388	0.462	9.013	0.003	4.009	1.619	9.926
HDL-C	-2.293	0.935	6.013	0.014	0.101	0.016	0.630
LDL-C	-1.909	0.638	8.953	0.003	0.148	0.042	0.517
脂蛋白	0.003	0.001	9.000	<0.01	1.003	1.002	1.004
GGT	0.003	0.006	0.250	0.596	1.003	0.992	1.014
hs-CRP	0.026	0.014	3.500	0.065	1.026	0.998	1.054
AFR	-0.322	0.072	19.800	<0.01	0.725	0.630	0.834