中国医学前沿杂志（电子版）2025，Vol.17Issue(4)：75-83,9.DOI:10.12037/YXQY.2025.04-12
80岁及以上冠状动脉粥样硬化性心脏病患者中应激性高血糖比值与冠状动脉病变严重程度的相关性
Association between the stress hyperglycemia ratio and severity of coronary artery disease in patients with coronary artery disease aged 80 years and above
摘要
Abstract
Objective To investigate the relationship between stress hyperglycemia ratio and severity of coronary artery disease in patients with coronary artery disease aged 80 years and above.Methods Coronary artery disease(CAD)patients aged 80 years and above who hospitalized in Beijing Hospital and underwent percutaneous coronary intervention(PCI)from January 1,2015,to December 31,2021 were consecutively enrolled enrolled.The patients'clinical data,including coronary angiography results,laboratory test results and echocardiography data were collected.According to the coronary angiography(CAG)results,patients were divided into single-vessel and multi-vessel lesions groups;according to the tertile of stress hyperglycemia ratio,they were divided into 3 groups(T1 group,stress hyperglycemia ratio(SHR)<0.867;T2 group,0.867≤SHR<1.115;and T3 group,SHR≥1.115),and the correlation between SHR and the severity of coronary disease was analyzed by logistic regression analysis.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to determine the sensitivity and specificity of SHR in predicting CAD severity.Controlling confounding factors,the restricted cubic spline plot was drawn to analyze the dose-response relationship between SHR and multi-vessel disease.Results A total of 486 patients were finally enrolled,including 286(58.8%)males and 200(41.2%)females with a median age of 82(81,84)years.Patients in the multi-vessel lesion group had higher SHR values than those in the single-vessel lesion group.According to the tertiles of SHR,the proportion of patients with multi-vessel lesions in the T3 group(91.9%)was higher than that in the other two groups(P<0.05).Logistic regression analysis showed that the SHR was an independent risk factor for multi-vessel lesions when used as a continuous variable after adjusting for risk factors(OR=3.718,95%CI:1.319-10.479,P=0.013).When SHR was used as a categorical variable,the risk of multi-vessel lesions in the T3 group was 2.106 times(95%CI:1.020-4.334,P<0.05)higher than that in the T1 group after adjusting for risk factors.SHR was associated with an increased risk of multi-vessel lesions in the diabetic group,whereas there was no significant association in the nondiabetic group(P for interaction=0.003).In addition,the area under the curve of SHR for predicting CAD severity was 0.606(95%CI:0.536-0.676).The restricted cubic spline analysis showed that there is a linear dose-response relationship between SHR and multi-vessel disease(Poverall=0.042,Pnonlinear=0.865).Conclusions SHR was significantly correlated with the risk of multi-vessel lesions and a predictor of coronary lesion severity in patients with CAD aged 80 years and above,especially in diabetic metillus patients.Monitoring SHR in elderly CAD patients is important for the evaluation of their condition and prognosis.关键词
80岁/冠状动脉粥样硬化性心脏病/冠状动脉病变程度/应激性高血糖比值Key words
Aged 80/Coronary artery disease/Severity of coronary artery disease/Stress hyperglycemia ratio引用本文复制引用
李慧敏,程雅琳,张闻多..80岁及以上冠状动脉粥样硬化性心脏病患者中应激性高血糖比值与冠状动脉病变严重程度的相关性[J].中国医学前沿杂志（电子版）,2025,17(4):75-83,9.基金项目
中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-001) CAMS Innovation Fund for Medical Sciences(2021-I2M-1-001) （2021-I2M-1-001）
